by Kimberly Allen, RN
Osteochondritis dissecans or OCD is a relatively rare condition that affects the joints. Though OCD can affect people at any age, it is most commonly diagnosed in young athletes. And just as in other conditions that are sports related, it has always been more common in males than females. However, with more and more females participating in sports activities, that gap has been closing.
Osteochondritis dissecans develops when a piece of bone along with it’s adjoining cartilage break away from the rest of the bone. OCD can develop in basically any joint in your body. However, the most commonly affected joints are the elbows and knees. Although there has been a lot of research into the cause of OCD it is still unclear exactly what causes it. Most researchers agree there is a loss of blood flow to the area which causes the piece of bone to die and break off. The question is, why is there a loss of blood flow? There are several theories that have evidence indicating cause and effect. The most common theory is repetitive physical trauma. This is particularly the case among young athletes. In these cases it is considered “repetitive microtrauma”. In other words repetitive motion injuries that are so mild they are either ignored or go unnoticed. If these “minor” injuries don’t heal properly scar tissue can develop obstructing blood flow. In adults, trauma is believed to be the number one cause of OCD. This trauma can occur either inside the joint or outside the joint, even both. Though trauma and repetitive micro trauma are believed to be the most common causes of OCD there are other potential causes including hereditary as well as endocrine factors. If there is an imbalance or deficiency in the rate of calcium to phosphorous there is the potential for a piece of bone to die off. Rapid bone growth and abnormal bone formation as well as diseases like avascular necrosis can also lead to the development of OCD.
Sometimes the piece of bone and cartilage that has died and separated from the bone will stay in place minimizing your symptoms. However, in may cases it falls into the joint space. When this happens the function of the joint is usually impaired and you will usually experience pain in the affected joint, which is usually triggered by activity. The affected joint then becomes inflamed as well as being sore and painful. The joint, especially the knee, tends to lock or catch during movement limiting the joints range of motion. It can also “give way” when the joint is stressed.
Because everyone is different there is no one treatment that works for all. For example, in teens that are still growing OCD may resolve with rest and protection. In most cases your doctor will recommend trying conservative measures like resting the affected joint and physical therapy. Various stretching and strengthening exercises as well as range of motion exercises can improve joint mobility. If after three to six months conservative treatments have not helped your doctor may recommend surgery to remove the pieces of bone and cartilage. The doctor will use a minimally invasive type of surgery known as arthroscopic surgery. In adult, OCD is less likely to resolve on it’s own and depending on your individual needs and preferences your doctor may recommend surgery much sooner. The goal of surgery is to restore normal blood flow and function to the joint.
The best way to prevent this type of injury is to learn what the potential risks are for your particular sport and then take precautions. Learning proper body mechanics as well as the proper techniques and mechanics of movements involved in your particular sport. Participate in a strength training program and learn stability training exercises.
As the participation in sporting activities has increased so has the number of injuries including osteochondritis dissecans emphasizing the need for proper, supervised training to limit and prevent injury.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at firstname.lastname@example.org.