Osteochondritis dissecans (OCD) is a common cause of knee disorder among skeletally immature and adult patients and it occurs when a small piece of subchondral bone begins to separate from its surrounding area due to a disturbance of the local blood supply. X-ray is the best initial test for suspected OD, but MRI is better able to detect early disease. Majority of patients are adolescent or young adult athletes. INTRODUCTION Osteochondritis dissecans (OCD) most often occurs in the knee, elbow, or ankle of the school-age or adolescent child where it causes pain. OD occurs as a result of overuse or trauma, and 75% of cases affect the knee. Left untreated, osteochondritis dissecans can lead to the development of osteoarthritis at an early age, resulting in progressive pain and disability. Osteochondritis dissecans is a condition that occurs in the joints (the place where the end of one bone meets the end of another bone) when a lack of blood to the joint causes the bone inside to soften. An unhealed lesion in an adult may be indicative of a juvenile onset of the condition. of subchondral bone in which a bone-. In the present article, the term osteochondritis dissecans (OCD) will be used to refer to mainly non-traumatic lesions in the child or adolescent, while the term osteochondral fractures will instead be used to indicate injuries of traumatic origin involving both the cartilage and the subchondral bone and occurring predominantly in adults. It is often associated with intra-articular loose bodies. Little has been published on the epidemio. PMCID: PMC6139592 DOI: 10.1177/1947603517715736 Abstract This article is a review of the current understanding of the etiology, pathogenesis, and how to diagnose and treat knee osteochondritis dissecans (OCD) followed by an analysis of and outcomes of the treatments available. are most commonly affected. Kessler JI, Nikizad H, Shea KG, Jacobs JC Jr, Bebchuk JD, Weiss JM. Symptomatic lesions in children, or skeletally immature patients, who do not have loose bodies. Initial treatment consists of rest, nonsteroidal . Bilateral in up to 25%. " Osteochondritis dissecans " means that thin pieces of inflamed, cartilage-covered bone are peeling away from the end of a long bone within a joint. Osteochondritis dissecans ( OCD or OD) is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone. adolescents. Sign up and get unlimited access. Medium-term studies have reported good results using autogenous osteochondral plugs (mosaicplasty). No more guessing. Majority of patients are adolescent or young adult athletes. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. The term OCD was first used by Koenig to explain the late formation of loose bodies in the knee joint. School-aged children and. Osteochondritis dissecans ( OCD) can occur in different joints, including the hip and ankle, but 75 percent of cases affect the knee. This content does not have an Arabic version. Epidemiological data refers to the US, unless otherwise specified. It has no known cause, but repetitive stress on the joint, low vitamin D and a genetic predisposition are often linked to this condition. 1 Although not necessarily an inflammatory process, the name has remained throughout the literature. Fixation with pins or screws with bioabsorbable fixation for loose and. Therapy for osteochondritis dissecans of the knee is guided in large part by the age of the patient. Believing that an underlying inflammatory reaction of bone and cartilage was a major component of this process, he selected the . Variable presentation: traumatic or atraumatic, insidious onset, nonspecific joint pain, exacerbation of . : While generally considered an idiopathic phenomenon, various etiopathogenetic theories are being investigated, including local ischemia . OCD is characterized by a loss of blood supply to one or more bones in the ankle, which may result in a fracture or break within the ankle joint. Proposed theories include mechanical stress and repetitive trauma. Bilateral in up to 25%. the unstable osteochondritis dissecans (OCD-type II and III according to the ICRS classification) of the knee largher than > 2.5 cm 2 in adults are uncommon lesions and there is no consensus on how to treat them. Buoy's symptom checker was built to empower its users in better understanding their medical symptoms. Most patients, especially children without a loose body, heal completely without complications. Osteochondritis dissecans nearly always occurs in the knee, especially at the far end of the thigh bone (femur). This can occur in any. The etiology is unknown. Skip to content Care at Mayo Clinic Care at Mayo Clinic About Mayo Clinic Request Appointment Osteochondritis dissecans is a bone and cartilage condition that most often occurs in the knee. [1] This may result in separation and instability of a segment of cartilage and free movement of these osteochondral fragments within the joint space. Osteochondritis dissecans is an idiopathic disease which affects the subchondral bone and its overlying articular cartilage due to loss of blood flow. Appointments & Access Contact Us Symptoms and Causes Patients typically retain the full range of motion in the affected joint. Symptoms Pain and swelling of a joint often brought on by sports or physical activity are the most common initial symptoms of OCD. In 1888, Konig coined the term when he sought to describe the pathologic process that led to atraumatic loose bodies of femoral origin in the knee and hip joints. Osteochondritis dissecans is a condition characterised by acquired pathological subchondral bone lesions and its incidence is unknown. Go to: [2] First-line treatment includes reducing physical activity. OCD is an acquired idiopathic lesion of subchondral bone that may produce delamination and sequestration with or without articular cartilage involvement ( 1 - 5 ). It commonly presents in adolescents and young adults. Osteochondritis Dissecans is a condition where loose fragments of bone and cartilage break off the end of a bone when the blood supply to the bone is reduced. cause of adult form is thought to be . cartilage. necrosis. Osteochondritis dissecans (OCD) is a common cause of knee pain and dysfunction among skeletally immature and young adult patients. Sign in to download full-size image Figure 5.27. Main joints involved include the knee, ankle, and radiocapitellar joint of the elbow. Plain radiographs are frequently diagnostic although magnetic resonance imaging (MRI) is typically necessary to further characterize the lesion. You have 3 free member-only articles left this month. OD occurs as a result of overuse or trauma, and 75% of cases affect the knee. No more endless Googling. This content does not have an English version. Osteochondritis dissecans is an idiopathic lesion of subchondral bone. Introduction. Osteochondritis dissecans of the knee is identified with increasing frequency in the young adult patient. We list the most important complications. : Osteochondritis dissecans occurs most frequently in the active pediatric and young adult populations, commonly affecting the knee, elbow, or ankle, and may lead to premature osteoarthritis. Surgery is indicated if the bone-cartilage fragment is completely displaced and includes arthroscopic extraction, open fixation, and transplantation procedures. Learn about the symptoms and treatment of this joint condition. Read the. Osteochondritis dissecans (OCD) of the knee is a somewhat rare cause of knee dysfunction and pain that has been recognized for over one hundred years, but the etiology is still poorly understood. These flakes of bone may come off completely or only partially. Knee arthroscopy, Osteotomy, Knee replacement, ACL surgery, Cartilage repair, Knee surgery, Meniscus repair, Multiligam. Osteochondritis dissecans (OCD) is the end result of the aseptic separation of an osteochondral fragment with the gradual fragmentation of the articular surface and results in an osteochondral defect. OD may be difficult to differentiate from, in patients with persistent symptoms and normal, Initially, rest and limited physical activity. Purpose. Osteochondritis dissecans is a radiographic diagnosis. The etiology of OCD remains controversial. Osteochondritis dissecans is another form of osteochondrosis. If the piece of cartilage and bone remain close to where they detached, they may not cause any symptoms. Osteochondritis Dissecans is a pathologic lesion affecting articular cartilage and subchondral bone with variable clinical patterns. adult Osteochondritis dissecans (OCD) is a disease that originates in the subchondral bone that affects the articular cartilage. ent knee reconstruction, Arthroplasty, Fresh osteochondral allograft reconstruction, Meniscus transplant, Sports injury, Lateral collateral ligament tear, Osteochondritis dissecans, Patellar fracture, Medial collateral ligament tear, Torn meniscus, Knee arthritis . . The name osteochondritis dissecans (OCD) is a misnomer. OD may be difficult to differentiate from osteonecrosis, but young patients are much more likely to have OD. School-aged children and adolescents are most commonly affected. Doctor Examination After discussing your child's symptoms and medical history, your doctor will perform a physical examination of the affected joint. The selection is not exhaustive. Abstract. Summary Osteochondritis dissecans is a joint condition that occurs when a piece of cartilage and the thin layer of bone beneath it, separates from the end of the bone. It has a multifactorial aetiology, with a combination of genetic and acquired risk factors. Main joints involved include the knee, ankle, and radiocapitellar joint of the elbow. Osteochondritis dissecans most commonly affects children who are very active in sports. Background:Osteochondritis dissecans (OCD) has frequently been described in children and adolescents, but cases of OCD in adults are certainly encountered. Osteochondritis dissecans is an idiopathic lesion of subchondral bone. [1] OCD usually causes pain during and after sports. Symptoms include pain and joint locking or catching. OCD occurs most often in children and adolescents. Osteochondritis dissecans (OD) is a focal aseptic. Diagnosis and treatment are discussed. Treatment of osteochondritis dissecans may include nonoperative or operative intervention. Symptoms include pain, swelling and stiffness. fragment detaches and becomes displaced in the joint space. Osteochondritis dissecans (OD) is a focal aseptic necrosis of subchondral bone in which a bone-cartilage fragment detaches and becomes displaced in the joint space. The demographics and epidemiology of osteochondritis dissecans of the knee in children and adolescents.. Evidence-based content, created and peer-reviewed by physicians. In children whose bones are still growing, the bone defect may heal with a period of rest and protection. Diagnosis may be made radiographically (notch view) but MRI usually required to determine size and stability of lesion, and to document the degree of cartilage injury. Signs and symptoms of OCD include: inflammation, swelling, and . Treatment of osteochondritis dissecans is intended to restore the normal functioning of the affected joint and relieve pain, as well as reduce the risk of osteoarthritis. No single treatment works for everybody. Therapy Advanced cases of OCD may cause joint catching or locking. Epidemiology Osteochondritis dissecans (OCD) is a condition in which a fragment of bone and cartilage separates causing pain, swelling and mechanical issues. [1] Other options depend on the stage and size of lesion, as well as skeletal maturity. It occurs when small pieces of cartilage and bone become dislodged in the joint due to a lack of blood flow. 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