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There are many ways you can help children and their families get the care they need.
Often, parents initially provide at-home aid for their child's injury before a doctor diagnoses osteochondritis dissecans (OCD). This home care usually follows the “R.I.C.E.” steps (rest, ice, compression and elevation), as well as medications to help control pain and swelling:
At Boston Children's Orthopedic Center we are proud to offer patients comprehensive care—including evaluation, diagnosis, consultation, non-surgical therapies, surgery and follow-up care.
Initial treatment follows the basic “R.I.C.E.” formula above, combined with non-steroidal anti-inflammatory medications for pain. Patients temporarily stop any running or impact sports activity. If the loose piece is stable (not detached), this conservative treatment may be all that's needed. Blood vessels sometimes can feed the outer edges of the injured bone, giving the piece the potential to heal on its own.
If your child's OCD doesn't heal on its own and the joint becomes painful, stiff or locked, he may need surgery.
Depending upon the type of OCD, your child's age and other factors, the doctor may recommend surgery to:
A child may still have an increased risk of premature arthritis (pain, inflammation, degeneration of the joint) in the joint following osteochondritis dissecans, even if surgery has been performed.
If your child is to have arthroscopic surgery to treat his osteochondritis dissecans, he may need a complete physical with his pediatrician before surgery to assess his health and rule out any conditions that could interfere with his surgery.
Before surgery, tell your child's doctor about any medications that he's taking. You'll be informed which medications he should stop taking before surgery. Typically, this includes aspirin and anti-inflammatory medications, which should be stopped 10 days before surgery.
Your doctor may also order tests—such as blood samples or an echocardiogram—to help prepare for your child's procedure.
After surgery, you and your child will be given written instructions, pictures of his surgery, a prescription for physical therapy and a copy of our rehabilitation guidelines. After surgery, a cast or brace will immobilize your child's joint for a period of time that your child's doctor will determine.
Your child will need to complete a course of rehabilitation exercises before gradually resuming his activity or sport. He'll meet with the physical therapist, who will recommend exercises, advise in wound care and how much weight he should place on the repaired joint. Throughout the rehab period, your Children's team will be available to answer questions, address your concerns and offer help.
A child has a great chance of returning to his usual activity level after treatment for osteochondritis dissecans, although he may not be able to keep playing high-impact sports.
After your child's joint has healed, and after his strength and stability have returned through physical therapy, he should be able to return to sports and activities—usually within six months. In fact, it's important for him to stay involved in some form of orthopedic fitness to ensure continued physical health and well-being.
But your child's doctor may recommend lifestyle changes for him if he has joint changes, such as arthritis or instability, that couldn't be corrected (even with surgery).
Your child's doctor will give you guidance about how long your child should rest his joint in order for it to heal. He'll need to avoid any activities that cause discomfort, and he may need to avoid impact sports for three to six months. Your doctor may suggest stretching exercises or swimming instead.
At Boston Children's Hospital, we understand that a hospital visit can be difficult, and sometimes overwhelming. So, we offer many amenities to make your child's—and your own—hospital experience as pleasant as possible. Our Center for Families staff will give you all the information you need regarding:
In particular, we understand that you may have a lot of questions when your child is diagnosed with osteochondritis dissecans. Will this affect my child long term? When can he return to his sports and activities? Children's can connect you with extensive resources to help you and your family through this stressful time, including:
The Division of Sports Medicine has cared for thousands of young athletes and is the health care choice of world-renowned dancers and professional athletes. We are the orthopedic caregivers for the Boston Ballet and the Boston Marathon.
With a long history of excellence and innovation and a team of clinicians and researchers at the forefront of orthopedic research and care, Children's is home to many treatment breakthroughs:
We are also:
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”