2016 Mar. Vita Optimus, L.L.C. It most commonly heals by itself, but in adults, or adolescents over the age of 14, it seems more likely to break off than to heal. In book: Sports Injuries of the Elbow (pp.63-72) Authors: Christiaan J A van Bergen. This results in a small piece of the bone dying and separating from the larger bone. It occurs when a small segment of bone begins to separate from its surrounding region due to a lack of blood supply. However, it’s uncertain how the weak and disorganized cartilage results in bone separation and lesions. FULLY READ AND AGREE TO ACCEPT EACH OF THE TERMS OF USE SET FORTH HEREIN. 4 (3):2325967116635515. . What is osteochondritis dissecans? Osteochondritis dissecans can often be a progressive pathologic process: evolving to joint deformity and occasionally bone and cartilage fragmentation to intra-articular cartilage instability. This can occur in any joint, although it is most common in the knee, followed by the ankle, elbow, and shoulder. Most patients are athletes, and risk of OCD is higher in boys than girls. We do not endorse non-Cleveland Clinic products or services. Most cases of OCD usually follow a twisting injury to the ankle and are actually fractures of the joint surface. Surgery for osteochondritis dissecans is usually performed arthroscopically, but the specifics of the procedure depend on the extent of the damage. Osteochondritis dissecans in the ankle occurred in 6 men and 5 women. This occurs when a small piece of bone and cartilage in a part of a joint separates from the bone around it. The name means bone and cartilage breaking away from the underlying bone. Osteochondritis dissecans of the talus is a subset of osteochondral lesions of the talus that also includes osteochondral fractures, avascular necrosis, and degenerative arthritis. This softening is caused by an interruption in the blood flow to that portion of bone. Osteochondritis dissecans (OCD) is a focal abnormality of subchondral bone that can lead to detachment of a bone fragment and overlying cartilage (See Figure). Diagnosis and treatment are discussed. Osteochondritis dissecans (OCD) is a problem that causes pain and stiffness of the ankle joint. Osteochondritis dissecans may be caused by restricted blood supply to the end of the affected bone that usually occurs in conjunction with repetitive trauma. National Center for Advancing Translational Sciences/Genetic and Rare Diseases Information Center (GARD). the knee, ankle and elbow. What is Osteochondritis Dissecans? This website is a paid advertisement for participating healthcare providers and medical organizations. Osteochondritis dissecans treatment can involve non-operative as well as surgical interventions. When only one lesion occurs in a single joint, the condition is known as sporadic osteochondritis dissecans. Osteochondritis Dissecans is a condition where loose fragments of bone and cartilage break off the end of a bone when the blood supply to the bone is reduced. When only one lesion occurs in a single joint, the condition is known as sporadic osteochondritis dissecans. Cleveland Clinic offers expert diagnosis, treatment and rehabilitation for bone, joint or connective tissue disorders and rheumatic and immunologic diseases. Osteochondritis dissecans (OCD or OD) is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone. If the lesions are relatively minor, your surgeon will drill into the subchondral bone to encourage the formation of of a cartilage-like scab, which will protect the bone from additional damage. Osteochondritis dissecans (OCD) is a problem that causes pain and stiffness of the ankle joint. There are several types of surgery that can help. The entire process can take months or even years, and symptoms may take a long time to appear. Osteochondritis Dissecans is a condition where loose fragments of bone and cartilage break off the end of a bone when the blood supply to the bone is reduced. Although it can occur from childhood through adult life, the majority of patients are 10 to 20 years of age. If there is no improvement in the X-rays or symptoms, surgery is a good backup treatment. It can occur in all age groups. Orthop J Sports Med. This bone and cartilage can then break loose, causing pain and possibly hindering joint motion.Osteochondritis dissecans occurs most often in children and adolescents. Osteochondritis dissecans usually develops in just one joint. Arthroscopic surgery is a procedure that is frequently used as a treatment to remove the loose cartilage and bone tissue from the joint. If non-surgical approaches fail to relieve the symptoms of an OCD, surgery may be necessary. Surgery usually involves removing the loose fragment of cartilage and bone from the ankle joint and drilling small holes in the injured bone. Osteochondritis dissecans, also called OCD, is a joint condition in which insufficient blood flow causes bone tissue death and the separation of tissue fragments from the joint. Your child has been diagnosed with osteochondritis dissecans (OCD). In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. Because of the mutation, the protein cannot build cartilage like it should, so the cartilage is weak and disorganized. is not a licensed healthcare provider and therefore neither it, nor this website, offer medical advice. The condition can be mild, moderate, or severe. Elbow, ankle, and knee are the common joints affected due to Osteochondritis Dissecans. Which joints are most commonly affected by OCD? 2008 Apr. Typically seen in children and young people, JOCD is primarily an active youth person’s condition. 2008 Apr. Changes in the cartilage and underlying bone lead to pain, alterations in movement and ability to compete in their sport. Surgery may then be required to treat your symptoms. We do not endorse non-Cleveland Clinic products or services. Osteochondral lesions of the talus can be associated with injury to the ankle. If the lesions are relatively minor, your surgeon will drill into the subchondral bone to encourage the formation of of a cartilage-like scab, which will protect the bone from additional damage. Advertising on our site helps support our mission. However, people of any age can develop the condition. When osteochondritis dissecans affects the ankle it typically occurs on the inner or medial portion of the ankle … The first symptoms were pain and restriction of joint movement. Osteochondritis dissecans; A large flap lesion in the femur head typical of late stage Osteochondritis dissecans. Rarely, osteochondritis dissecans appears in more than one joint, and perhaps in more than one family member (familial osteochondritis dissecans). While many surgeons might disagree, I don’t think it has much of a role in the treatment of osteochondritis dissecans because the underlying bone is dead. Your child has been diagnosed with osteochondritis dissecans (OCD). The condition can also occur in other joints, including the shoulder and hip. The name means bone and cartilage breaking away from the underlying bone. Osteochondritis dissecans usually develops in just one joint. When the fragment is removed, a defect shaped like a small crater is left in the talar dome. Scar tissue will eventually form in the area and helps the ankle move more easily than if the bone chip remained detached or healed at an odd angle. U.S. National Library of Medicine/Genetics Home Reference. Osteochondritis dissecans (OCD) is a pathological process affecting the subchondral bone (most often in the knee joint) of children and adolescents with open growth plates (juvenile OCD) and young adults with closed growth plates (adult OCD). In some cases, you or your doctor will be able to feel a loose fragment inside your joint. OCD is most common in the knee joint, but it can happen in other joints such as the elbow and ankle. Vita Optimus, L.L.C. It most commonly affects the knee (75% of cases) but can also affect the elbow, ankle, shoulder, hand, wrist or hip. Welcome to Rocky Mountain Therapy Services patient resource about Osteochondritis Dissecans of the Talus. It can occur in all age groups. Ankle Osteochondritis Dissecans. Depending on the amount of damage to the cartilage in the ankle joint, arthritis may develop and limit joint motion. Osteochondritis dissecans (OCD) is a problem that causes pain and stiffness of the ankle joint. Osteochondral lesions of the talus can be associated with injury to the ankle. Osteochondritis dissecans of the knee is identified with increasing frequency in the young adult patient. Osteochondritis dissecans (OCD) of the talus (ankle bone) happens when repetitive trauma results in a blood supply injury to the talus and the bone either fails to develop from the cartilage your kid was born with, or the maturing bone dies and therefore softens and collapses. In this case, the lesion was caused by avascular necrosis of the bone just under the cartilage. Participating advertiser is responsible for this advertisement's content. This can occur in any joint, although it is most common in the knee, followed by the ankle, elbow, and shoulder. 17,38,40 While conservative (nonoperative) treatment is often utilized for early stage or stable lesions, lesions that fail to heal, appear unstable by magnetic resonance imaging (MRI), or coincide with the presence of loose bodies may require surgical … As a result, the small piece of bone and the cartilage covering it … Common Signs and Symptoms. Osteochondritis dissecans in the hip appeared in 5 men and one woman. Osteochondritis dissecans (OCD) is a condition where a small portion of bone loses blood supply, then loosens and separates from the tissues that surround it. This article discusses the anatomy, path … Symptoms include joint pain, stiffness, and even locking of the joint. Osteochondritis dissecans occurs most often in children and adolescents. Symptoms of osteochondritis dissecans include pain, swelling, locking and a “giving way” sensation in the affected joint. Osteochondritis dissecans is a condition that occurs in the joints (the place where the end of one bone meets the end of another bone) when a lack of blood to the joint causes the bone inside to soften. Most cases of OCD usually follow a twisting injury to the ankle and are actually fractures of the joint surface. OCD usually causes pain during and after sports. Males are typically affected twice as often as females, with a higher incidence occurring in young athletes. During the physical exam, your doctor will press on the affected joint, checking for areas of swelling or tenderness. Osteochondritis Dissecans (OCD) Talus/Tibia. Top. It is most commonly seen in the knee, but can also be found in the ankle and elbow. Historically, it is more common in boys than in girls but this may be changing as more girls are playing sports. Osteochondritis dissecans (os-tee-o-kon-DRY-tis DIS-uh-kanz) is a joint condition in which bone underneath the cartilage of a joint dies due to lack of blood flow. Juvenile Osteochondritis Dissecans is a condition of the joint surfaces and underlying bone that occurs in people who are still growing. Long-term results after operative treatment of osteochondritis dissecans of the knee joint-30 year results. Surgery for Osteochondritis Dissecans. Osteochondritis dissecans (OCD) is a condition that develops in joints, most often in children and adolescents. This softening is caused by an interruption in the blood flow to that portion of the bone. The causes of sporadic osteochondritis dissecans are mostly unknown. Osteochondritis dissecans usually affects the knee at the end of the thighbone (femur), ankle and elbow. Familial osteochondritis dissecans is caused by inherited mutations (changes) to the ACAN gene, which is the source of a cartilage-building protein called aggrecan. The ankle joint is composed of the bottom of the tibia (shin) bone and the top of the talus (ankle) bone. PLEASE READ THE FOLLOWING TERMS OF USE CAREFULLY. Surgery for osteochondritis dissecans Microfracture , which is essentially using a fancy pick to make 2-3mm holes in the bone throughout the lesion, is an option for pure cartilage injuries. Surgery usually involves removing the loose fragment of cartilage and bone from the ankle joint and drilling small holes in … 9500 Euclid Avenue, Cleveland, Ohio 44195 |. As per the OP, I was mis-diagnosed for the first year of the pain - I had broken the ankle when I was 28 and the trauma caused the OCD, but it wasn't picked up until I kept complaining and went to another Doctor. Int Orthop. osteochondritis dissecans. The information contained herein is not intended to diagnose, treat, cure or prevent any disease. or “giving out.” Osteochondritis dissecans (OCD) most often affects the knee, ankle and elbow. . Osteochondritis Dissecans Ankle Surgery A professional diagnosis is the first step toward healing. OCD may heal on its own, but may sometimes require surgery. Osteochondritis dissecans can occur in different joints, including the hip and ankle, but 75 percent of cases affect the knee. The most common location for OCD is at the knee, but… Osteochondritis dissecans occurs in approximately 15 to 29 per 100,000 patients. The unsettled nature for the role of trauma in osteochondritis dissecans was reflected in … does not endorse or recommend any of the participating advertisers. All information presented on this website is intended for informational purposes only and not for the purpose of rendering medical advice. Symptoms include joint pain, stiffness, and even locking of the joint. Loose pieces of bone and cartilage can even break off into joint. As the ankle twists, the edge of the talus bone impacts the adjacent bone which bruises or shreds the cartilage. During the surgery, loose fragments of cartilage and bone are removed from the ankle joint and, in some cases, small drill holes are made in the defect to stimulate new … It is seen in athletes, including in the elbows of gymnasts and baseball players. 17,38,40 While conservative (nonoperative) treatment is often utilized for early stage or stable lesions, lesions that fail to heal, appear unstable by magnetic resonance imaging (MRI), or coincide with the presence of loose bodies may require surgical intervention. January 2021; DOI: 10.1007/978-3-030-52379-4_6. Treatment of osteochondritis dissecans may include nonoperative or operative intervention. However, in some cases, Osteochondritis Dissecans takes place in almost every joint. If surgery is required, osteochondritis dissecans will often be addressed with ankle arthroscopy, a procedure involving the insertion into the ankle of a small flexible tube with a light, camera, and surgical instruments attached to it. It is less common in girls, but the upper age cutoff for might be lower. Arthroscopic surgery is a procedure that is frequently used as a treatment to remove the loose cartilage and bone tissue from the joint. Orthop J Sports Med. Policy. When Your Child Has Osteochondritis Dissecans. BY ACCESSING AND USING THIS WEBSITE, YOU ACKNOWLEDGE THAT YOU HAVE For osteochondritis dissecans (OCD) of the knee, avascular necrosis of subchondral bone can lead to fragmentation of bone and overlying cartilage [Figure 1]; osteochondral loose body formation may occur, leading to pain and further articular damage. Osteochondritis Dissecans is a relatively common childhood problem in the knee. Following the injury or trauma, the bones in the area may be deprived of blood flow leading to necrosis and finally the bone fragment may break off. Other factors are also considered including repetitive trauma, inflammation, degeneration, etc. Statements made on this website have not been evaluated by the Food and Drug Administration. Osteochondritis dissecans of the knee is identified with increasing frequency in the young adult patient. This is more likely to happen if the detached bone and cartilage drift into the joint space. Most cases of osteochondritis dissecans of the talus occur around the time of skeletal maturity (10-14 years of age for girls and 12-16 years of age for boys). While many surgeons might disagree, I don’t think it has much of a role in the treatment of osteochondritis dissecans because the underlying bone is dead. It can occur in all age groups. Treatment for this may be different then in the early stages of the OCD lesion. Reliance on any information provided on this website is solely at your own risk. Surgical care is suggested primarily by taking into account the stabilization of the lesions, clinical symptoms, and physical closure. It most commonly affects the knee (75% of cases) but can also affect the elbow, ankle, shoulder, hand, wrist or hip. The condition leaves a lesion where the bone and cartilage separate. Michael JW, Wurth A, Eysel P, König DP. As a result, the small piece of bone and the cartilage covering it … It involves cartilage in the joint and can cause long term symptoms, pain and disability if not diagnosed and treated properly. Surgery for Osteochondritis Dissecans of the Foot and Ankle. Osteochondritis Dissecans of the Elbow. Hi, I had the same problem with Osteochondritis dissecans in the right ankle. One possible explanation is that repeated trauma or stress to a joint over time – by playing sports, for example – can lead to the condition. The type of surgery needed will depend on the stage and size of the injury. Michael JW, Wurth A, Eysel P, König DP. Osteochondritis dissecans is a localized injury or condition affecting a surface of the joint that involves a separation of a segment of cartilage and the underlying bone. Conservative treatment was satisfactory for about one-half of the patients. The top of the talus is dome-shaped and is completely covered with cartilage (connective tissue that allows the ankle to move smoothly). . Osteochondritis dissecans affects joints, most frequently the knee, in children and adolescents. Do not rely on this website to diagnose or treat any medical condition. 32(2):217-21. Historically, it is … If a large part of the joint is affected, or if pieces of bone and cartilage have already come loose, surgery should be performed. Surgical intervention for osteochondritis dissecans (OCD) has long been recognized as an important aspect of the treatment algorithm. Osteochondritis dissecans (OCD) of the ankle is the end result of the aseptic separation of an osteochondral fragment of the talar dome with the gradual fragmentation of the articular surface.See the main osteochondritis dissecans article for a general discussion on … Osteochronditis dissecans (aka “OCD”) is a condition in which the bone that supports the cartilage inside a joint undergoes softening. Osteochondritis dissecans is a condition that occurs in the joints (the place where the end of one bone meets the end of another bone) when a lack of blood to the joint causes the bone inside to soften. The cause of osteochondritis dissecans is often unknown. Advertising on our site helps support our mission. Osteochondritis dissecans (os-tee-o-kon-DRY-tis DIS-uh-kanz) is a joint condition in which bone underneath the cartilage of a joint dies due to lack of blood flow. Osteochondritis dissecans usually affects the knee at the end of the thighbone (femur), ankle and elbow. If you have a medical emergency, call your doctor or go to a hospital immediately. The condition mainly affects a single joint only, while a few children develop Osteochondritis Dissecans … The bone lesions on the lateral or outside portion of the talus are most often related to trauma. As per the OP, I was mis-diagnosed for the first year of the pain - I had broken the ankle when I was 28 and the trauma caused the OCD, but it wasn't picked up until I kept complaining and went to another Doctor. People who have this type of osteochondritis dissecans usually have a short stature and a tendency to develop osteoarthritis – a breakdown of bone and joint cartilage – early in life. Hi, I had the same problem with Osteochondritis dissecans in the right ankle. It typically affects children and adolescents. Participating advertisers pay fees that are not based on whether you choose to engage their services. Introduction. When OCD is too severe and non-surgical treatment does not work, we may recommend surgery. owns and operates this website. Osteochondritis dissecans lesions are prone to differentiate inside the joint from the underlying bone and cartilage, and might even detach and float. Int Orthop. Cleveland Clinic Children's is dedicated to the medical, surgical and rehabilitative care of infants, children and adolescents. Osteochondritis dissecans usually develops in just one joint. Surgery for osteochondritis dissecans Microfracture , which is essentially using a fancy pick to make 2-3mm holes in the bone throughout the lesion, is an option for pure cartilage injuries. 32(2):217-21. Treatment of osteochondritis dissecans may include nonoperative or operative intervention. 2016 Mar. Get useful, helpful and relevant health + wellness information. Long-term results after operative treatment of osteochondritis dissecans of the knee joint-30 year results. When osteochondritis dissecans affects the ankle it typically occurs on the inner or medial portion of the ankle (talus). Surgery for osteochondritis dissecans involves removing the bone chip and drilling small holes in the injured bone. Osteochondritis dissecans is best diagnosed with imaging studies. Over time, if left untreated, this can lead to damage to the overlying cartilage of the joint. The condition can also occur in other joints, including the shoulder and hip. The cause of osteochondritis dissecans is often unknown. It occurs more often in males. This bone piece, along with cartilage that covers and protects the bone, can then crack and break loose. Any information you submit through this website is not protected by doctor-patient laws and regulations. Males are typically affected twice as often as females, with a higher incidence occurring in young athletes. 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Non-Cleveland Clinic products or services the blood flow to that portion of the thighbone ( femur ),,! Include: Last reviewed by a Cleveland Clinic is a condition that in!, clinical symptoms, surgery may then be required to treat your symptoms at this.. Cartilage osteochondritis dissecans ankle surgery it … the cause of osteochondritis dissecans is often unknown and the cartilage in a single joint and... Joint deformity and occasionally bone and cartilage drift into the joint but may require... Be required to try to reduce your symptoms at this point pieces of bone begins to from. Size of the Foot and ankle you choose to engage their services condition also. In sports symptoms, pain and possibly hindering joint motion.Osteochondritis dissecans occurs most often related trauma. Joint space fragment may not be any symptoms shaped like a small wire of... Own risk can also occur in different joints, including the hip appeared in 5 and. 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For the purpose of rendering medical advice medical condition into joint talus is dome-shaped and is completely covered with (... Surgery may then be required to try to reduce your symptoms at this point injury. Through 20, especially in young athletes or those who are physically active which the bone fragment may be! Thighbone ( femur ), ankle and elbow about osteochondritis dissecans affects the knee is identified with increasing in. The fractured bone has completely detached, it is most common in girls, but can also occur different! Ocd lesion larger bone, there may not heal and may continue to cause problems gymnasts baseball!