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Orthopaedic Conditions Affecting Children and Adolescents – Osteochondritis Dissecans (OCD)

What is OCD?

Osteochondritis dissecans (OCD) is a condition of the joints that affects children and adolescents between the ages of 10 – 20 who are active in sports with males more commonly affected than females at a ratio of 2:1. It occurs near “ossification” centres (areas where bone tissue is being formed).

When does it occur and who is at risk?

OCD occurs when a small bone segment suffers from a lack of blood supply and starts to separate from its surrounding region.  This causes a “cracking and loosening” of the small piece of bone as well as the cartilage that covers it.

Although OCD can occur in all joints, it most commonly occurs in the knee as well as the elbow and ankle. Usually the condition only affects one joint, but some children can have OCD occur in multiple joints.

What causes OCD?

OCD is caused by a disruption to the blood supply – but it is unknown as to what causes this disruption. We believe that the causes are multifactorial and probably involves combinations of different factors including trauma or stress to the bone, genetic predisposition and possibly abnormality in the ossification centres.

What are the symptoms of OCD in the knee joint?

Initial symptoms are most commonly brought on physical or sporting activity, walking up stairs or climbing hills and can include:

  • Pain and swelling of the knee joint.

More advanced symptoms can include:

  • The knee joint feeling like it is “popping or locking”. This is because a loose fragment of bone may get caught during movement and cause the joint to “stick” in one position.
  • The knee joint feeling weak and having a feeling of “giving way.”
  • Decreased range of motion not allowing the knee to straighten completely

What are the treatment options for OCD?

There is no single treatment that works for everyone.

Nonsurgical Treatment

OCD lesions in younger children and teens who are still growing in most instances will heal on their own.

In these cases, we may recommend therapy that includes:

  • Resting the joint. This will include avoiding activities that place stress on the knee joint including sporting activity and running. In some cases crutches will be recommended – in particular if the pain is causing a limp; and where the joint needs to be immobilised we may suggest a splint, cast or brace (less common).
  • Physical therapy treatment that includes stretching, strengthening and range of motion exercises.

Surgical Treatment

Grown children and young adults can experience more severe effects from OCD lesions as they have a greater chance of becoming separated from the surrounding bone and cartilage. If this occurs, the lose bone may become detached and float around within the joint.

In these instances, surgery is usually required.

The type of surgery necessary will be dependent upon the individual case and takes into account the size and stage of the lesion and how mature the bones are.

How can Dr Shidiak help?

Dr Shidiak is a leading specialist in the management of nonsurgical and surgical treatment for OCD in children and adolescents.

The correct diagnosis, management and treatment for OCD will help to ensure your child is able to continue to their regular sporting activities and lead a full and active life.

To get a diagnosis and understand your child’s condition and what the best possible treatment options are, please call our office to arrange for a consultation with Dr Shidiak on 02 9806 3333.

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