Osteochondritis Dissecans

Cartilage and Bone Damage in the Knee

Osteochondritis Dissecans (OCD), pronounced ‘Oss-tee-oh-kon-DRITE-iss DISS-ih-kanzis’, a joint condition that occurs when a small segment of bone underneath the cartilage in your knee loses its blood supply. This loss causes the bone and the cartilage covering it to become loose, potentially leading to pain, swelling, and reduced mobility. The condition is most common in children and adolescents who are still growing, but it can also occur in adults. If left untreated, OCD can lead to long-term knee issues, including early-onset osteoarthritis.

WHAT CAUSES OSTEOCHONDRITIS DISSECANS?

Osteochondritis dissecans (OCD) occurs when a small section of bone beneath the joint’s cartilage loses its blood supply. This can cause the bone and the overlying cartilage to weaken and, in some cases, become loose or detach. While the exact cause isn’t always clear, several contributing factors may play a role.

Repetitive Stress or Overuse: Frequent high-impact activities, such as jumping, running, or pivoting, may place repeated pressure on the joint, leading to damage over time, particularly in young athletes.
Joint Trauma: A direct injury to the joint, such as a fall or a sporting collision, may disrupt the blood supply to the underlying bone and trigger OCD.
Growth-Related Changes: OCD is most common in adolescents during periods of rapid growth. Uneven development or increased stress on a growing joint may contribute to the condition.
Genetic Factors: Some individuals may have a genetic predisposition that affects bone development or blood supply, although research is ongoing in this area.
Reduced Blood Flow to the Bone: In some cases, there may be no clear injury or stress, but a spontaneous loss of blood supply to the bone can still lead to the development of OCD.

Understanding the potential causes of osteochondritis dissecans is an important step in early diagnosis and effective management, particularly in younger individuals and active patients.

SYMPTOMS OF OSTEOCHONDRITIS DISSECANS

The symptoms of osteochondritis dissecans (OCD) can vary depending on the severity of the condition and whether any loose fragments have formed inside the joint. In some cases, symptoms may be mild and develop gradually, while in others, they may appear suddenly — especially following activity or injury.

Common symptoms include:

Knee Pain: Pain is the most common symptom and is often felt during or after physical activity. It may start as a dull ache and become more noticeable with continued movement.
Swelling and Tenderness: You may notice swelling around the joint, along with tenderness when pressing on the affected area.
Joint Stiffness: The knee may feel stiff, particularly after periods of rest or inactivity, and it may be difficult to fully straighten or bend the leg.
Locking or Catching Sensation: If a piece of bone or cartilage becomes loose, it can interfere with the smooth movement of the joint, causing it to temporarily lock or catch during motion.
Joint Instability or Giving Way: Some individuals experience a feeling that the knee might buckle or give out, particularly during activities that involve twisting or turning.
Reduced Range of Motion: There may be a noticeable decrease in how far the knee can move, often making everyday activities such as squatting, kneeling, or going up stairs more difficult.

If left untreated, OCD may lead to long-term joint problems, including arthritis. Recognising these symptoms early and seeking assessment can help prevent further damage and support more effective treatment.

HOW IS OSTEOCHONDRITIS DISSECANS DIAGNOSED?

Accurate diagnosis is an important step in effectively managing osteochondritis dissecans (OCD). Dr Liddell will begin with a detailed evaluation to understand your symptoms, activity levels, and any previous injuries that may have contributed to the condition.

The diagnostic process typically includes:

Medical History and Symptom Review: Dr Liddell will ask about the onset and nature of your symptoms, your physical activity, and any past knee injuries or conditions.
Physical Examination: Your knee will be carefully assessed for swelling, tenderness, stability, and range of motion. Specific tests may be used to check for joint stiffness, pain during movement, or signs of instability.
X-Rays: Standard X-rays can reveal changes in the bone, including any loose fragments or irregularities in the joint surface. They also help rule out other causes of knee pain.
MRI Scan: An MRI provides a detailed image of the knee’s soft tissues and underlying bone. It can detect whether the affected bone and cartilage have become loose or detached and is especially helpful in planning treatment.

Through this comprehensive approach, Dr Liddell can accurately diagnose OCD and determine the most appropriate course of action to relieve your symptoms and protect the long-term health of your knee.

TREATMENT OPTIONS FOR OSTEOCHONDRITIS DISSECANS

Treatment is based on the severity of the condition, your age, and whether any loose fragments are present. Dr Liddell will recommend the most appropriate approach to support healing, reduce pain, and restore function.

Activity Modification and Rest: Reducing or avoiding high-impact movements can give the joint time to heal, particularly in younger patients with developing bones.
Physiotherapy: A tailored rehabilitation program helps strengthen the muscles around the joint, improve stability, and support recovery.
Bracing or Immobilisation: A supportive knee brace may be used to offload pressure on the affected area and promote healing in early-stage cases.
Pain Relief and Anti-Inflammatory Medication: Medications may be used to manage discomfort and reduce inflammation during the recovery process.
Surgical Treatment: Surgery may be recommended if the bone or cartilage is loose, or if non-surgical measures are not effective. Options may include:
- Drilling or Microfracture Techniques: To stimulate healing in the bone.
- Fixation of Loose Fragments: Using pins or screws to stabilise the damaged area.
- Cartilage Restoration Procedures: Such as grafts or implants in more advanced cases.

Dr Liddell will guide you through your treatment options and develop a personalised plan to best support your recovery and long-term joint health.

PREVENTING OSTEOCHONDRITIS DISSECANS

While it may not be possible to completely prevent OCD, there are steps you can take to reduce your risk:

Avoid Overuse: Limiting repetitive, high-impact activities can reduce stress on your knees, particularly during periods of rapid growth in adolescence.
Strengthen Your Muscles: A strong core and leg muscles provide better support for your knees, reducing the risk of injury.
Use Proper Technique: In sports, using the correct technique and equipment can help protect your joints from excessive strain.
Pay Attention to Pain: If you experience knee pain during activity, it’s important to rest and seek medical advice rather than pushing through the pain.

If you are experiencing knee pain or suspect you may have Osteochondritis Dissecans, Dr Antony Liddell offers expert diagnosis and treatment options tailored to your condition. With a focus on restoring knee function and preventing long-term complications, Dr Liddell can help you return to your daily activities or sports with confidence.