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Osteochondritis dissecans (OCD) is a condition in which the bone that supports the cartilage of a joint softens. This softening is caused by an interruption in the blood flow to that portion of bone. If left untreated, this softening can lead to damage of the cartilage in the joint.
No one knows exactly what causes OCD, but it has been associated with specific injuries as well as long-term repetitive impact to the joint.
Cartilage injury is similar to OCD, but it is caused by an acute injury to the cartilage and underlying bone. It can happen in association with ligament injuries, such as tearing of the ACL.
Although any joint’s bone and cartilage can be involved, OCD and cartilage injuries most commonly affect the knee, ankle and elbow.
Anyone can get an OCD or cartilage injury, although children and adolescents involved in sports with running and jumping are more likely to experience these kinds of injuries. Gymnasts and baseball players are especially susceptible to OCDs in the elbow.
As young athletes experience chronic stresses to their knee, ankle or elbow, the combination of repetitive stress, micro-trauma and poor blood supply to the area results in cartilage damage.
The signs and symptoms of OCD include the onset of pain with increased activity, swelling, loss of full range of motion in a joint, or clicking or popping sensations. These symptoms may begin to appear after a patient has experienced a small injury, which had seemed to improve.
The signs and symptoms of an acute cartilage injury are more obvious. There is usually a known injury with rapid knee swelling and difficulty putting weight on the extremity. There may also be a sensation of clicking and locking of the involved joint.
OCD and cartilage injuries are diagnosed by x-ray and magnetic resource imaging (MRI).
At the Sports Medicine Program for Young Athletes at Children’s Hospital Colorado, there are many treatments for OCD. In patients who are still growing, we treat mild OCDs with rest and a recommendation to decrease running, jumping and throwing activities. Activities can be resumed gradually once symptoms are resolved and there is evidence of healing on x-rays. Mild OCDs have a good chance of healing without surgery and pose minimal risk for arthritis.
More advanced OCDs, or those in older adolescents, are treated with surgery. We use minimally-invasive surgical methods to reestablish blood flow and cartilage restoration/repair techniques. Some more advanced techniques include arthroscopic surgery (a minimally invasive surgical procedure) and bone transplantation/grafting procedures. Most patients are good candidates for the arthroscopic surgeries.
Recovery time from surgery ranges from 12 weeks for the arthroscopic procedures to six months for the more invasive techniques.
Acute cartilage injury, if diagnosed early, can sometimes be treated by repairing the torn cartilage piece. More complicated defects and injuries are treated by the more advanced surgical techniques for cartilage restoration.
Pediatrics, Sports Medicine