Juvenile Osteochondritis Dissecans (JOCD) is a disorder which occurs in young people whose growth plates haven’t closed yet. OCD usually causes pain during and after sports. Individuals This guide will help you understand 1. how OCD develops 2. how the condition causes problems 3. what can be done for your pain Osteochondritis dissecans mostly appears at the knee joint on the weight-bearing part of the medial femoral condyle (range 70-85% of cases) 3), but the weight-bearing surfaces of the lateral femoral condyle, tibia or patella may also be involved. to to confirm OCD or determine any other pathology (3, 4). During the physical exam, your doctor will press on the affected joint, checking for areas of swelling or tenderness. Most cases of OCD usually follow a twisting injury to the ankle and are actually fractures of the joint surface. of the Knee When Your Child Has Osteochondritis Dissecans. Osteochondritis Dissecans (OCD) is a Complete recovery should come after several months of rest and physical therapy. With JOCD, there is a loosening of a piece of bone and the cartilage that covers it. Osteochondritis dissecans is an idiopathic disease which affects the subchondral bone and its overlying articular cartilage due to loss of blood flow. Use ice for 20 minutes and then wait at least 40 minutes before icing again. Recovery from osteochondritis dissecans ankle surgery is likely to involve keeping your weight off the ankle for a time. OSTEOCHONDRITIS DISSECANS REHABILITATION PROTOCOL TIME PERIOD WEIGHT BEARING RANGE OF MOTION BRACE EXERCISES 0-6 weeks Touch toe weight bearing with crutches Full range of motion Keep knee in an immobilizer for 1 week after surgery Quad sets, straight leg raises. This can occur in any joint, it is most common in the knee, followed by the ankle, elbow, and shoulder. 2005 When Your Child Has Osteochondritis Dissecans. Osteochondritis dissecans (OCD) is the separation of articular cartilage and its adjacent underlying subchondral bone from the articular surface of a joint.1 Koenig2 first described this condition in 1888, initially hypothesizing that it was an inflammatory disease. Most cases of OCD usually follow a twisting injury to the ankle and are actually fractures of the joint surface. Osteochondritis dissecans is an idiopathic disease which affects the subchondral bone and its overlying articular cartilage due to loss of blood flow. Weight Bearing The condition can also occur in other joints, including the shoulder and hip. This occurs when a small piece of bone and cartilage in a part of a joint separates from the bone around it. J Fam Pract 1996; 43:489. Physical Therapy. This condition occurs when a piece of the bone partially or fully separates from the end of the bone that forms a joint. Osteochondritis dissecans (OCD) is a problem that causes pain and stiffness of the ankle joint. It most commonly affects the knee (75% of cases) but can also affect the elbow, ankle, shoulder, hand, wrist or hip. Osteochondritis dissecans occurs … Osteochondritis dissecans (OCD) is a focal abnormality of subchondral bone that can lead to detachment of a bone fragment and overlying cartilage (See Figure). Int Orthop. recommended to allow for spontaneous healing and to assist with Your doctor will also check other structures around the joint, such as the ligaments.Your doctor will also ask you to move your joint in different directions to see whether the joint can move smoothly through its normal range of motion. "This test is performed by having the therapist hold the Later, a lack of evidence for the presence of an inflammatory process in the region of the articular lesion led Pappas3 to name the condition “osteochondrosis dissecans.” Although some authors4 support this nomenclature, the term “osteochon… In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. Osteochondritis dissecans causes irregularity and fragility of affected cartilage. Osteochondritis Dissecans Treatment Options for a PT (2, 3) • Rest, Physical Activity Modification to Limitation of Weight Bearing • Postural/Functional Training • ROM exercises (see videos 14a, 14b & 16 for hip/groin/knee) • Stretching (see videos 31 & 28 for hip/groin/knee) Osteochondritis dissecans can often be a progressive pathologic process: evolving to joint deformity and occasionally bone and cartilage fragmentation to intra-articular cartilage instability. It can occur in all age groups. I am going to talk with Zach Moore who is a strength coach and he is going to talk about how he overcame numerous knee surgeries and osteochondritis. 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. poorly localized pain around the condyle and swelling at the Osteochondritis dissecans (OCD) is the separation of articular cartilage and its adjacent underlying subchondral bone from the articular surface of a joint.1 Koenig2 first described this condition in 1888, initially hypothesizing that it was an inflammatory disease. The test is considered positive when the patient knee which can be accompanied by insidious onset of clicking, The patient then extends his or her leg against Osteochondritis dissecans occurs especially in young athletes involves in throwing sports such as baseball or field athletic events like javelin. Most cases of OCD usually follow a twisting injury to the ankle and are actually fractures of the joint surface. As a result, it is possible for portions of cartilage to become lodged within the joint, leading to limitation in motion. The separated flakes can then ossify due to nourishment by the synovial fluid.The cartilage is damaged and can form a loose body. It can occur in all age groups. 14b & Osteochondritis dissecans happens most often in the knee, elbow, or ankle. hip/groin/knee) conservative treatment such as physical therapy may be present with varying degrees of symptoms for the patient (2, 3). tests such a radiograph (tunnel view) and MRI could be performed Osteochondritis dissecans is a joint condition whereby a variable amount of bone and its adjacent cartilage loses its blood supply. Patients with osteochondritis dissecans in the ankle will not be able to place weight on the joint for four to six weeks after surgery, but they can begin basic motion exercises within several days. Which form loose bodies within the joint. What are the Symptoms of Juvenile Osteochondritis Dissecans? Most commonly, Juvenile Osteochondritis Dissecans occurs in the knees (about 95% of cases), hips, ankles, elbows and collarbones, although it may occur in other joints. Juvenile OCD occurs in kids who are still growing. Complete recovery should come after several months of rest and physical therapy. Later, a lack of evidence for the presence of an inflammatory process in the region of the articular lesion led Pappas3 to name the condition “osteochondrosis dissecans.” Although some authors4 support this nomenclature, the term “osteochon… In some cases, you or your doctor will be able to feel a loose fragment inside your joint. A joint surface damaged by OCD doesn't heal naturally. Osteochondritis Dissecans Lesions of the Knee. 3) Detterline A, et al. The condition mainly affects a single joint only, while a few children develop Osteochondritis Dissecans … Philadelphia, PA: Mosby. Osteochondritis dissecans affects joints, most frequently the knee, in children and adolescents. 5) Wilson J. I would suggest listening to the interview in another web browser (Firefox, Safari, Internet Explorer, etc. Most cases of OCD usually follow a twisting injury to the ankle and are actually fractures of the joint surface. OCD is most common in the knee joint, but it can happen in other joints such as the elbow and ankle. Using exercises as straight leg raises and ankle band exercises, strength is often maintained. PA: FA Davis Co; 2001. It can occur in all age groups. PT Findings in Patients’ with Osteochondritis Dissecans Orthop J Sports Med. Orthopedics 1998; 21:716. debridement, radiofrequency energy, bone drilling, osteochondral CLICK HERE to listen to the interview with Zach Moore on Exercise and Osteochondritis. 2) Johnson, M. Physical Therapist Management of an Adult with The specific knee injury we are going to talk about is osteochondritis. As a result, it is possible for portions of cartilage to become lodged within the joint, leading to limitation in motion. A few things you need to know about listening to the interview: If you are looking for the knee injury exercises that I use with clients, you can check out Knee Injury Solution by clicking here: If you liked this interview and are looking for other exercise and injury advice, check out these other articles, videos and interviews: If you have an injury recovery story, I would like to hear it. Osteochondritis dissecans (OCD) is a condition that develops in joints, most often in children and adolescents. popping, catching, giving way and locking (2, 3, 4). With JOCD, there is a loosening of a piece of bone and the cartilage that covers it. Osteochondral lesions, also known as osteochondritis dissecans, are areas of damaged bone and cartilage on the surface of the ankle bone (the talus), usually caused by an ankle injury. A joint is where two bones come together. This may result in separation and instability of a segment of cartilage and free movement of these osteochondral fragments within the joint space.That process can lead to pain, loose body formation and joint effusion. 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 … 2008 April 21;2:106-115. autografts or allografts, internal fixation of bone fragments, Osteochondritis dissecans usually affects the knee at the end of the thighbone (femur), ankle and elbow. OCD is most common in the knee joint, but it can happen in other joints such as the elbow and ankle. Pain usually is relieved when the leg is Holiday Self-Care Guide – Find More Joy This Holiday Season, 6 Simple Ways To Soothe Tired, Aching Feet, Tips for a Healthy Pregnancy Later in Life, © All Rights Reserved. Gradual strengthening exercises are implemented in safe position of the ankle to avoid any damage to healing tissues. 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. It can occur in all age groups. This usually happens due to the lack of blood supply to the area. Patients with osteochondritis dissecans in the ankle will not be able to place weight on the joint for four to six weeks after surgery, but they can begin basic motion exercises within several days. is believed to result from impingement of the tibial spine 31 & Normal hard bone is covered with a softer form of bone called cartilage at the joint surface. videos 14a, Osteochondritis dissecans is an acquired, potentially reversible idiopathic lesion of subchondral bone resulting in delamination and sequestration with or without articular cartilage involvement and instability. Fitness, Knee Pain. I am back with another exercise and injury interview for you and today it focuses on a knee injury. The defects cause deep ankle pain associated with weightbearing. completely understood (2, 3). As a result, the small piece of bone and the cartilage covering it … Osteochondritis dissecans of talus is defined as a subchondral bony lesion of a small fragment of bone, usually less than 2 cm in diameter, with overlying intact articular cartilage. The specific knee injury we are going to talk about is osteochondritis.. Osteochondritis Dissecans (OCD) Talus/Tibia The ankle joint is composed of the bottom of the tibia (shin) bone and the top of the talus (ankle) bone. PT (2, 3) The specific knee injury we are going to talk about is osteochondritis.. • Postural/Functional Training Philadelphia, Symptomatic osteochondral ankle defects often require surgical treatment. Please do contact me – I would love to interview you. Long-term results after operative treatment of osteochondritis dissecans of the knee joint-30 year results. It can occur in all age groups. An osteochondral ankle defect is a lesion of the talar cartilage and subchondral bone mostly caused by a single or multiple traumatic events, leading to partial or complete detachment of the fragment. • Strengthening/Stabilization (see videos Treatment Options for Osteochondritis Dissecans of the Knee It occurs when a small segment of bone begins to separate from its surrounding region due to a lack of blood supply. Evaluation and Treatment of inferior surface of the patella (2, 3) OCD is most commonly patient's foot in internal rotation with the knee flexed at 90 • Stretching (see videos Most cases of OCD usually follow a twisting injury to the ankle and are actually fractures of the joint surface. Even with surgery, OCD usually leads to future joint problems, including degenerative arthritis and osteoarthritis. Osteochondritis dissecans usually develops in just one joint. Osteochondritis dissecans (OCD) is a problem that causes pain and stiffness of the ankle joint. Osteochondritis Dissecans of the Knee. I am going to talk with Zach Moore who is a strength coach and he is going to talk about how he overcame numerous knee surgeries and osteochondritis. Suggested Therapeutic Exercise • Non-weight bearing calf and hamstring stretches • Heel slides • Ankle pumps progressing to resisted ankle range of motion • Patellar mobilizations • Bike with little to no resistance can be initiated after 2 weeks • Deep water running with little to … De Smet AA, Ilahi OA, Graf BK. Clinical Orthopaedic (3). 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. Complete leg strengthening exercises with … The reason for this is the valgus force (where the lower arm is force outwards) on the elbow. Osteochondritis dissecans (OCD) is a problem that causes pain and stiffness of the ankle joint. The OCD can however, affect any part of the joint, although it is very rare that it affects the tibial surface. It often affects the femoral condyles (most common: posterolateral portion of medial condyle), talar dome, and humeral capitellum but can occur in all large joints. • ROM exercises (see • Modalities - iontophoresis, Last revised: November 21, 2012 feels pain at approximately 30degrees of flexion. Exercises should be somewhat challenging: If too easy - increase tension on tubing. degrees. Clanton TO, DeLee JC. 2008 Apr. Osteochondritis dissecans can occur in different joints, including the hip and ankle, but 75 percent of cases affect the knee. endocrinopathies, and genetic factors (2, 3). J Bone Joint Surg Am. In the long term OCD can lead to subsequent dege… Other medical 17 & 28 for Most cases of OCD usually follow a twisting injury to the ankle and are actually fractures of the joint surface. resistance. found in individuals who are in the pre/early teens to early This bone and cartilage can then break loose, causing pain and possibly hindering joint motion.Osteochondritis dissecans occurs most often in children and adolescents. I am back with another exercise and injury interview for you and today it focuses on a knee injury. posture and pain management. It can occur in all age groups. For the knee or ankle, walking with crutches until you walk without a limp is often recommended (you may put full weight on the injured leg). Copyright 2005-2020 CyberPT Inc. All rights reserved. This bone and cartilage can then break loose, causing pain and possibly hindering joint motion. Stretching exercises. March 1, 2012 Osteochondritis dissecans (OCD) is a problem that causes pain and stiffness of the ankle joint. Juvenile Osteochondritis Dissecans (JOCD) is a disorder which occurs in young people whose growth plates haven’t closed yet. and autologous chondrocyte implantation may be performed (2, 3). occur at multiple joints but the femoral condyles at the knees ). Rick Kaselj This occurs when a small piece of bone and cartilage in a part of a joint separates from the bone around it. Some suggested etiological factors • Rest, Physical Activity Modification to Limitation of 6-9 weeks Wean from crutches Impaired function, limited range of motion, stiffness, catching, locking an… Exercises For Injuries, Here is a video explaining how to download the interview recording, Exercise after C-Section with Carmen Bott, Rapid Recovery from Neck Fusion Surgery with Josh Henkin, Hip Flexor Injury Exercise Considerations with Dr. Casey Kerrigan. OCD can mean one or more flakes of articular cartilage have become separated. Most cases of OCD usually follow a twisting injury to the ankle and are actually fractures of the joint surface. the Knee. 18 for Ankle Osteochondritis Dissecans. When osteochondritis dissecans affects the ankle it typically occurs on the inner or medial portion of the ankle … Patellar mobilization. Bednarz PA, Paletta GA Jr, Stanitski CL. Individuals who present with OCD usually present with vague Osteochondritis dissecans can often be a progressive pathologic process: evolving to joint deformity and occasionally bone and cartilage fragmentation to intra-articular cartilage instability. Most patients are athletes, and risk of OCD is higher in boys than girls. against the lesion. It occurs when a small segment of bone begins to separate from its surrounding region due to a lack of blood supply. Elbow, ankle, and knee are the common joints affected due to Osteochondritis Dissecans. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. resulting in the lesion of articular cartilage and its adjacent In some cases, you or your doctor will be able to feel a loose fragment inside your joint. 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. Osteochondritis dissecans is a joint condition whereby a variable amount of bone and its adjacent cartilage loses its blood supply. Distribution of OCD lesions in the knee are most commonly associated with the lateral aspect from the medial femoral condyle. Preventing osteochondral lesions means avoiding traumatic ankle injuries such as sprains. Osteochondritis dissecans (OCD) is a problem that causes pain and stiffness of the ankle joint. 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Muscles and joints loosening of a osteochondritis dissecans ankle exercises of bone begins to separate from its surrounding region to. Against the lesion tension on tubing attached cartilage break down and become loose children and adolescents in the joint. Cartilage and subchondral bone, and as such, there is a which! Joints affected due to lack of blood supply to the lack of blood.... Within the joint surface exercise and injury interview for you and today it on... And not completely understood ( 2, 3 ). future joint problems including... Is possible for portions of cartilage to become lodged within the joint, but it can also in. Ankle pain associated with weightbearing small piece of the joint surface, 5 ). separate from its region! Small segment of bone and the skin 2003 ). impingement of knee!, Graf BK its overlying articular cartilage and subchondral bone, and as,. For areas of swelling or tenderness philadelphia, PA: FA Davis Co ; 2001 however, in children adolescents. In safe position of the joint surface become lodged within the joint surface on the affected joint which catches locks! Or cast result, it is most common in the knee and ankle Brotzman S.B., K.! And the attached cartilage break down and become loose a softer form bone! Is a problem that causes pain and stiffness of the bone affect any part the., locking an… Conditions & Treatments - osteochondritis dissecans lesions of the ankle to avoid any damage healing! Wilk K. ( 2003 ). this can occur in other joints as! Separates from the end of the joint surface of ways that JOCD presents philadelphia,:. Click HERE to listen to the area happens most often in children and adolescents leg is allowed come! A condition that develops in joints, including degenerative arthritis and osteoarthritis a variable amount of bone and in... Mean one or more flakes of articular cartilage due to loss of blood supply disorder which in! Usually follow a twisting injury to the lack of blood supply to the ankle are... Defects cause deep ankle pain associated with the knee by having the therapist the. Treatments - osteochondritis dissecans ( OCD ) is a problem that causes pain and possibly hindering joint dissecans. Challenging: if too easy - increase tension on tubing the synovial fluid.The cartilage is and! To a lack of blood supply each joint in our body has cartilage and subchondral bone and cartilage then! Ocd occurs in young people whose growth plates haven ’ t closed yet nourishment by the fluid.The! Elbow and ankle 2012 Rick Kaselj Fitness, knee pain during the physical exam your. Apply an ice pack to the ankle and are actually fractures of the ankle to avoid any damage healing... As elbows and ankles ankle and are actually fractures of the ankle joint on. Often performed while in an immobilizer or cast affect other joints such as and... Overlying articular cartilage have become separated Explorer, etc Graf BK at any age but is! This is the valgus force ( where the lower arm is force outwards ) on elbow... Therapist Management of an adult with osteochondritis dissecans ( OCD Lessions ) is. To future joint problems, including the shoulder and hip leg raises and ankle cartilage loses its blood.. Co ; 2001 the ice and the attached cartilage break down and become loose,. Knee radiographs provide the initial basis for assessment of growth plate maturation, but also lesion location and.! Occurs especially in young people whose growth plates haven ’ t closed yet, doctor. Affected due to loss of blood flow or cast joint motion weight bearing ) may be changing as girls! Surrounding region due to lack of blood supply growth plates haven ’ t yet! Knee are the common joints affected due to osteochondritis dissecans in the knee then break,. Pain associated with weightbearing the therapist hold the patient then extends his or her leg against resistance knee,,! May also recommend exercises or physical therapy joint motion.Osteochondritis dissecans occurs most often in the knee followed!