Knee Osteochondritis Dissecans (OCD) An unusual cause of knee pain is that of osteochondritis dissecans (OCD). Cartilage can also come loose due to damage in the underlying bone, OCD, or osteonecrosis. If a lesion is seen the contralateral knee should also be xrayed. Diagram shows the classic four signs of instability in an OCD lesion: 1, high signal intensity rim at the interface between the fragment and the adjacent bone on T2-weighted MR images; 2, fluid-filled cysts beneath the lesion; 3, a high-signal-intensity line extending through the articular cartilage overlying the lesion; and 4, a focal osteochondral defect filled with joint fluid. OCD of the Knee. This will need surgery to repair. In fact, this is the a common source of loose bodies in the knee joint. OCD Lesion: Diagnosis, Evaluation and Management - Geoffrey Van Thiel, MD (CSMS #45, 2018) Knee & Sports - Osteochondritis Dissecans OCD is one of the more significant causes of pain – and has been discussed already. An OCD Lesion occurs usually in the knee, elbow, and ankle. AP films alone may miss a lesion on the posterior aspect of the medial femoral condyle. If OCD of the knee is suspected, AP, lateral, notch-view (knee in flexion) and skyline patella xrays should be ordered. When OCD affects the knee, the most common location is within the lateral aspect of the medial femoral condyle. Each of these did have appropriate bite and were buried beneath the articular surface. Cartilage damage is most frequently seen between the ages of 15 and 30 or above the age of 50. A lesion of the cartilage and bone due to necrosis and loss of continuity of the underlying bone. Theodore Ganley MD, Kevin Shea MD. In the world of childhood knee injuries and complaints, there are few mysteries that still persist. Particularly in adolescent male athletes, OCD of the knee is a common source of pain, effusion, and mechanical symptoms with sporting activities. Unless the lesion repairs spontaneously or it is treated, the disease process progresses. Enjoy the videos and music you love, upload original content, and share it all with friends, family, and the world on YouTube. The knee is the location most often requiring surgery, with 58% of procedures for OCD lesions being performed on the knee. Various modalities and techniques exist, such as fixation, debridement, microfracture, and cartilage grafting/transplantation. In summary, OCD is an abnormality of subchondral bone that most commonly affect the medial femoral condyle of the knee. The authors’ preferred treatment algorithm for osteochondritis dissecans (OCD) of the knee is based on skeletal maturity, OCD lesion stability, and OCD lesion salvageability. To determine if mechanical axis deviation correlates with OCD lesion location in the knee, if degree of mechanical axis deviation correlates with size of OCD lesion, and if the deformity was primarily in the distal femur or proximal tibia. Study Design: Cross-sectional study; Level of evidence, 3. When present, OCD lesions usually become symptomatic during a child’s development. Juvenile OCD lesions have a better healing prognosis than adults. Following this, I was able to range the knee. Other lesions may be more appropriately treated with surgery. Most areas of scientific inquiry concerning the knee revolve around the major ligaments and our knowledge of these injuries is so far advanced that often the remaining questions are minor fine-tuning. Once the OCD is hinged open, the bed of the lesion is prepared. The lesion is then hinged open. It was once believed that all OLTs progress and worsen with time. For unstable yet salvageable OCD lesions, the senior author’s preferred treatment is fixation with bone grafting. OCD starts when a small area of bone just under the knee’s smooth cartilage loses some of its blood supply. There was no evidence of rocking of the lesion or of catching within the knee. … Diagnosis can be made with plain radiography, and the lesion can be further characterized by MRI. This video demonstrates the treatment of an unstable osteochondritis dissecans (OCD) lesion of the knee. 2 UWSPORTSMEDICINE.ORG 621 SCIENCE DRIVE • MADISON, WI 53711 4602 EASTPARK BLVD. By Dr. Eric W. Edmonds . Adults are less … Surgical Treatment . Sometimes, high impact activities, like basketball, can be difficult to play after OCD. The ankle OCD lesion is rare in the pediatric population, mainly occurring in adults with the average age being 21 years of age. For a knee OCD lesion, your child may be placed on crutches for up to 6 weeks. Osteochondritis Dissecans of Knee (OCD) What is osteochondritis dissecans (OCD)? If neglected, the OCD may come loose, catch in the joint, (causing pain, locking, clicking, etc.) This has been shown to no longer be true. * This results in a spectrum of pathology beginning with a lesion to the bone only,… There is a history of trauma to the knee in 40% of patients. However, when the OCD lesion is more mature and has separated from the rest of the bone, either with the overlying cartilage intact, partially separated or completely separated (loose body), surgery is often needed to stimulate, graft, stabilize, or remove the OCD fragment. OCD is characterized by the separation of an osteochondral fragment from its surrounding bone and cartilage tissues. Multiple theories have been proposed for the cause of an OCD lesion in the knee, including trauma or repetitive microtrauma, local vascular insufficiency, and family history. There is an association with trauma to the ankle, particularly in lateral talar dome lesions. Knee pain (especially anterior knee pain) is common in the young athlete. Osteochondritis dissecans (OCD) of the knee is a debilitating disorder primarily affecting adolescents and young adults at a rate between 15 and 30 per 100,000 , . An OCD lesion is an area within the knee where the bone underneath a small area of cartilage starts to die. promote OCD lesion healing, fixation methods, and salvage techniques. It is more common in boys and is generally bilateral. The cause is currently unknown but it may lead to damage to overlying cartilage, loose bodies, and joint damage. • Retroarticular or transarticular drilling of a non-healing, stable OCD lesion in the pediatric knee … We did drill several holes at the base of OCD lesion prior to re-fixation. lesion of the knee. Osteochondritis Dissecans (OCD) is a condition that affects the articular cartilage and the subchondral bone of the knee. 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