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Osteochondritis in Children

  • Overview

    We advise kids not to specialize in just one sport. Multi-sport athletes tend not to get as many OCD injuries and other kinds of overuse injuries. As for practicing, we advise kids and coaches to alternate exercises and vary drills.

    --Yi-Meng Yen, MD, PhD, orthopedic surgeon, Boston Children's Hospital

    More and more kids are playing organized sports, and they’re specializing in one sport at an early age. While exercise and athletics are hugely beneficial for children and adolescents, there’s an element of risk that offsets some of the benefits: Overuse injuries like osteochondritis dissecans (OCD) are on the rise.

    If your child or teen has been diagnosed with OCD, we know that he’s experiencing discomfort, as well as some disappointment at the disruption of his sports training. At Children’s Hospital Boston, we’ll approach your child’s treatment with sensitivity and support. We want to get him back to his normal activities—and back into his game—safely.

    About osteochondritis (OCD)

    • OCD and other overuse injuries are sports-related microtraumas (small injuries) that result from repetitively using the same parts of the body.
      • OCD can have other causes, too, such as trauma, a genetic predisposition, rapid growth and bone formation anomalies.
    • OCD is a joint disorder in which a loose piece of bone and cartilage separates from the end of the bone because of a loss of blood supply.
    • In kids and teens, OCD injury most often affects the knee (high-impact landings) and elbow (pitching, throwing).
    • OCD can affect both boys and girls, but is most common in boys 10 to 20 years old.
    • Signs and symptoms of OCD injury include:
      • a “popping” sensation
      • soreness, tenderness at the joint line
      • swelling or stiffness
      • difficulty straightening the joint fully
      • feeling like the joint is locking, “catching” or “giving way”
      • collection of fluid (“water on the knee”)
    • Treatment in kids is usually non-surgical, but surgery can be necessary in serious cases.
    • If untreated, OCD can lead to early osteoarthritis—chronic joint inflammation causing pain and damage to the joint.
    • The risk of OCD can often be reduced with:
      • proper conditioning and training (especially cross-training)
      • sport-appropriate equipment and protective gear
      • adequate rest between exercise sessions

    The detailed information on the following pages will help you gain a better understanding of OCD and other overuse injuries and a clearer picture of how to help your child recover from one.

    Boston Children's Hospital approach to osteochondritis dissecans and overuse injuries

    At Children's, our doctors are committed to repairing your child's joint with the least invasive option possible. The team in Boston Children’s Orthopedic Center has treated thousands of children, adolescents, adults and professional athletes with injuries ranging from the minor to the highly complex. We can provide your child with expert diagnosis, treatment and care—as well as the benefits of our advanced clinical and scientific research.

    Our orthopedic experts have cared for many generations of young athletes and we are the health care choice of professional athletes and world-renowned dancers. We are the official orthopedic caregivers for the internationally famous Boston Marathon and the Boston Ballet.

    We provide comprehensive assessment, treatment and follow-up care to children, adolescents and young adults who have sports-related orthopedic injuries. Our skilled orthopedists and sports medicine experts work with physical therapy staff to develop long-term treatment and activity plans. Our team has also developed innovative evaluation programs and effective injury prevention programs and strategies.

    Our orthopedic team includes 24 orthopedic surgeons, 10 primary care sports medicine specialists, two podiatrists, a nutritionist, a sports psychologist, eight physician assistants, 14 nurses and four certified athletic trainers. Besides our busy Boston practice, Children's physicians see hundreds of patients every week at our locations in Lexington, Weymouth, Peabody and Waltham. Our surgeons perform an average of 5,000 surgical procedures each year.

    We’re known for our science-driven approach—we’re home to the most extensive research enterprise located in a pediatric hospital in the world. As part of our research efforts, we’re working to create a way to help jump-start the knee into healing itself.

    Osteochondritis dissecans: Reviewed by Yi-Meng Yen, MD, PhD
    © Boston Children's Hospital, 2011

    Boston Children's Performs for the Boston Ballet

    Our Division of Sports Medicine provides comprehensive medical care for dancers in the Boston Ballet, which has more than 50 full-time, top-trained performers. In addition, through a unique partnership with the Division of Sports Medicine, students from Boston Ballet’s summer dance program—one of the premier ballet training programs in the nation—receive physical therapy from Children’s specialists with expertise in dance-specific injuries.

The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”
- Sandra L. Fenwick, President and CEO