Osteochondritis Dissecans (OCD)

What Is OCD?

Osteochondritis Dissecans or OCD of the knee is a condition that affects the joint where your thigh bone and shin bone meet. In this condition a small piece of bone and the cartilage that covers it begin to loosen because they are not receiving enough blood supply. When this happens the bone and cartilage can become unstable which leads to pain swelling and stiffness in the knee.

If the condition is not treated the loose piece can break free and cause long-term damage to the joint surface. This may make it harder to stay active and can increase the risk of arthritis later in life. OCD most often appears in children and teenagers who are very active in sports but adults can develop it as well. Early diagnosis and proper care are important because treatment options can range from rest and physical therapy to surgery depending on how severe the problem is.

Causes

While the exact cause isn’t fully understood, several factors may contribute:

Repetitive stress or injury from sports or physical activity
Genetics, as OCD sometimes runs in families
Blood flow issues that reduce nourishment to the bone and cartilage
Growth-related changes, since the condition is most common during adolescence
Previous trauma to the knee such as a hard fall or impact
Abnormal bone development or alignment that increases stress on the joint
Rapid growth spurts that can put added strain on bones and cartilage

Symptoms

OCD symptoms can vary, but common signs include:

Knee pain that worsens with activity
Swelling or tenderness around the joint
Stiffness or decreased range of motion
A “catching” or “locking” feeling if a loose fragment is present
Limping or favoring one leg
A feeling that the knee is unstable or “giving way”

Diagnosis

Doctors use a combination of approaches to diagnose OCD:

Reviewing medical history and symptoms such as pain, swelling, or instability
Physical examination to check for tenderness, swelling, range of motion, or joint stability
X-rays to look for changes in the bone structure
MRI scans to view cartilage health and detect unstable lesions early
Occasionally CT scans or other imaging tests if more detail is needed

Treatment

Treatment depends on the patient’s age, the stability of the lesion, and how advanced the condition is:

Non-surgical care: Rest, activity changes, physical therapy, and sometimes bracing. These approaches are most effective in younger patients whose bones are still growing.
Surgical care: If non-surgical options are not enough, surgery may be recommended. Procedures can fix the lesion in place, remove loose fragments, or restore the damaged bone and cartilage.
Rehabilitation: Whether treated with or without surgery, guided physical therapy is important to rebuild strength, improve mobility, and restore confidence in the knee.

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Understanding Knee OCD

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