Osteochondritis Dissecans (OCD) for the Orthopedic Patient

Important information:

Osteochondritis dissecans (OCD) is a condition affecting the joints. With OCD, a fragment of bone or cartilage partially or completely separates from the underlying bone.

In mild cases of OCD, the fragment will stay in place in the bone. In more severe cases, the fragment completely separates and falls into the joint.

OCD happens most often during adolescent and teenage years, but the condition may occur at any age. It usually affects one joint. But in some instances, it may affect multiple joints.

The knee is the most common site affected. The elbow and ankle are less commonly affected. Although even less common, OCD has also been found in the shoulder, wrist, hand, and hip joints.

The exact cause is unknown. Trauma, interruptions in blood supply to the bone, uneven or excessive pressure on a joint, and genetic factors have all been thought to cause OCD.

Symptoms of OCD

• Pain and swelling

• Pain increases with strenuous activity and twisting motions

• Joint may become “stuck” or “locked” in a position for a period of time

• A sense of instability of the joint

Testing and diagnosis

X-rays can confirm the presence and location of OCD. MRI is used to evaluate the overlying cartilage and the affected bone beneath the cartilage. CT scans and bone scans are used less often.

Treatment of OCD

Early forms of OCD may be treated by a simple change in your child’s activity level. This sometimes includes changing or stopping sports or activity participation. Most cases of OCD may require immobilization with casts or braces.

OCD that does not improve or becomes worse may need surgical treatment. If surgery is necessary, your team will explain the surgical procedure to you and answer all your questions.

When can my child return to their activities?

In mild cases requiring changes in activity, bracing, or casting, your child can return to play when the OCD is healed. This is determined by follow-up x-rays. Your provider may recommend swimming or stretching exercises during this period. They may also need a course of physical therapy to help return to activities. Ultimately, your healthcare team will determine when your child may return to physical activity.

Division of Orthopaedics

Weekdays:

215-590-1527 if your cast was placed in our Philadelphia, Princeton or Voorhees sites.

If your cast was placed in our King of Prussia office, call 215-590-6919.

Nights, weekends, and holidays:

Call 215-590-1000 and ask the operator to page the orthopedic resident on call.

Reviewed March 2024 by Alison Lehman, PA-C