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Osteochondritis Dissecans

Idiopathic focal subchondral bone necrosis with potential separation of overlying articular cartilage forming intra-articular loose bodies in adolescents and young adults.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Ortopedi ve Travmatoloji department. Book Appointment →

What is Osteochondritis Dissecans?

Osteochondritis dissecans (OCD) is a focal idiopathic alteration of subchondral bone with secondary effects on adjacent articular cartilage; the lesion progresses through stages from subchondral edema to partial separation, displaced fragment, and loose body formation.

Most commonly affects the lateral aspect of the medial femoral condyle of the knee (juvenile or adult OCD), capitellum of the elbow (in throwing or gymnastics athletes), and talar dome of the ankle; bilateral involvement in 30% of cases.

Etiology multifactorial — repetitive microtrauma, vascular compromise, abnormal subchondral ossification, and genetic predisposition; presentation in skeletally immature patients (juvenile form) has better prognosis than skeletally mature adult form which often requires surgical intervention.

Symptoms

Activity-related joint pain (knee, elbow, ankle)
Joint swelling after activity
Mechanical symptoms — locking, catching, giving way
Stiffness and decreased range of motion
Tenderness over affected area
Effusion in advanced stages
Loose body sensation with displaced fragment

Risk Factors

Adolescence and skeletal immaturity (juvenile OCD)
Male sex (3-4 times higher than female)
Repetitive impact sports (running, jumping, throwing)
Family history of OCD
Discoid meniscus (knee OCD)
Repetitive throwing in baseball pitchers (elbow capitellum)
Recurrent ankle sprains (talar dome OCD)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent activity-related joint pain in adolescent
  • Joint swelling and mechanical symptoms
  • Locking or catching sensations
  • Failed conservative treatment after 6 weeks
  • Loose body sensation
  • Restriction in athletic performance
  • Bilateral joint pain with similar pattern

Treatment Methods

01
Conservative — activity restriction, immobilization, physical therapy for stable juvenile lesions
02
Subchondral drilling (transarticular or retroarticular) for stable lesions failing conservative treatment
03
Internal fixation with screws or biocompatible pins for unstable in situ fragments
04
Fragment excision and microfracture for irreparable fragments
05
Osteochondral autograft transfer (OATS) or allograft for large defects
06
Autologous chondrocyte implantation (ACI/MACI) for cartilage defects
07
Post-operative rehabilitation with progressive weight-bearing and range of motion

Which Department to Visit?

You can visit our Ortopedi ve Travmatoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.