Indications
Osteochondritis dissecans (OCD) is a localized injury or condition affecting the bone just below the cartilage surface of a joint. OCD is often associated with repetitive trauma and sports. In OCD, the involved bone just below the joint surface fails and fractures from repetitive stress or from interruption of its local blood supply. Eventually, the overlying cartilage, not properly supported by the affected bone, can separate and an osteochondral fragment of bone and cartilage can break loose resulting in a hole in the joint surface and a loose body that can catch and cause painful mechanical symptoms. The resulting hole and irregularity of the joint surface will accelerate the wear and tear of the cartilage surface and arthritis of the knee joint. If the OCD lesion is stable (not loose) and the patient is still growing, conservative treatment of rest sometimes can allow it to heal. However, when the OCD lesion is more mature and has separated from the rest of the bone, surgical repair of the OCD may be necessary. If the cartilage surface is still intact over the OCD, anarthroscopic cartilage preserving approach from behind the OCD lesion can debride any intervening soft-tissue, “break -up” sclerotic non-healing bone, bone graft defects, and an apply fixation to stabilize and stimulate the OCD to encourage healing.
Contraindications to Surgery
- Intection in the knee
- Inability or unwillingness to complete the postoperative program of limiting activity after surgery and to complete the necessary rehabilitation