Osteochondritis dissecans (OCD) is a knee condition where a small piece of bone and its cartilage covering become unstable. This can cause pain, swelling, and eventually arthritis if not treated. It most often affects young athletes but can happen to adults too.
Doctors usually try non-surgical treatments first, like rest and activity changes, but surgery is needed when the problem doesn’t heal or the piece becomes unstable. The main goals of surgery are to:
Improve blood supply so the bone can heal.
Stabilize the loose piece so it stays in place.
How surgeons treat OCD today:
- Drilling: Tiny holes are made in the bone to bring in fresh blood and help healing.
- Bone marrow injections (BMAC): Special cells from the patient’s own hip bone are concentrated and injected into the lesion to boost repair.
- Bone grafting: Healthy bone is taken from another spot and placed under the damaged area to fill gaps and improve healing.
- Fixation devices: Screws, pins, or strong sutures (stitches) are used to hold the bone piece in place while it heals. Some screws dissolve over time; others may need to be removed later.
- Suture bridge technique: Instead of screws, strong threads anchor the cartilage piece down. This can be useful if there isn’t much bone attached.
The big picture:
There’s no one “perfect” treatment yet, and doctors choose the method based on how stable the piece is, the patient’s age, and how much bone is involved. Research is ongoing to learn which options work best, but new techniques like marrow injections and advanced fixation are giving doctors more tools to save the joint and delay or prevent arthritis.
