What is osteochondritis dissecans?

Osteochondritis dissecans (OCD) is a joint condition that occurs when bone separates from cartilage and starts to die. It’s usually due to a lack of blood flow to the bone. When small pieces of the separated bone and cartilage start to break loose, it can cause pain and reduce your range of motion in the affected area.

While OCD can affect any joint, 75 percent of cases involve the knee. Read on to learn more about OCD, including common symptoms and how it’s treated.

OCD usually doesn’t cause any symptoms in its early stages, when the bone hasn’t separated from cartilage. However, as this starts to happen, you might notice the following around the affected joint:

  • pain
  • swelling
  • tenderness
  • popping sound
  • locking sensation
  • weakness
  • decreased range of motion

You might notice that your symptoms are worse following high-impact activity, such as running or jumping.

Experts aren’t sure what causes OCD. However, it might be related to repeated, small injuries to the joint from high-impact activities.

Some cases of OCD also have a genetic component. This is known as familial osteochondritis dissecans, which tends to affect multiple joints. People with familial osteochondritis dissecans are usually short and have early-onset osteoarthritis.

Osteochondritis dissecans is most common in children and teenagers between 10 and 20 years old who play sports. It’s tends to affect more males than females.

To diagnose OCD, your doctor will start by doing a basic physical exam and checking for any tenderness or swelling in your joints. They may ask you to perform a few movements so they can evaluate your range of motion around the affected joint.

Based on the results of your exam, they might also order some imaging tests:

  • X-rays will help them see if a bone has separated from the cartilage.
  • MRI scans will give them a view of the cartilage so they can see if it’s still in the proper place.
  • CT scans allow your doctor to check for any loose fragments of bone or cartilage that might be adding to your symptoms.

OCD often heals on its own, especially in children who are still growing. However, other cases might require treatment to restore joint function and reduce your risk of developing osteoarthritis.

Nonsurgical treatment

Sometimes, the affected joint just needs to rest. Try to avoid doing strenuous or high-impact activities for a few weeks to give your joint time to heal. Your doctor might also recommend using crutches or wearing a splint to prevent your joint from moving too much.

Conservative treatment entails resting from strenuous or high-impact activity, to give the joint time to heal. In some cases, your doctor might recommend using crutches or splinting the joint to allow it to rest more fully.

Surgical treatment

If your symptoms don’t improve after four to six months, you might need surgery. Your doctor will also likely recommend surgery if you have loose bone or cartilage fragments in your joints.

There are three main approaches when it comes to surgery for OCD:

  • Drilling. Your doctor will use a drill to make a small hole in the affected area. This encourages new blood vessels to form, increasing blood flow to the area and helping it heal.
  • Pinning. This involves inserting pins and screws to hold the lesion of a joint in place.
  • Grafting. Your doctor takes bone or cartilage from other areas of your body and places it in the damaged area, grafting new bone or cartilage onto the damaged area.

After surgery, you’ll probably need to use crutches for about six weeks. Your doctor might also recommend doing physical therapy for several months to help you regain strength. You should be able to start returning to your usual activity level in about five months.

OCD in children and teenagers often heals on its own. Other cases may require resting the area for several weeks or undergoing surgery. While most people make a full recovery, having OCD can increase your risk of eventually developing osteoarthritis in the affected joint. You can reduce your risk by following up with strength and stability training, combined with periods of rest.