Osteochondritis Dissecans | Diagnosis & Treatments

How is osteochondritis dissecans diagnosed?

To diagnose osteochondritis dissecans, an orthopedic specialist will take a medical history and perform a physical exam on your child. The doctor will check for pain along the affected joint line and may order an x-ray or MRI to help them see the joint.

Diagnosing OCD of the knee, elbow, and ankle

To diagnose osteochondritis dissecans, your child’s doctor will assess the affected joint for any swelling or tenderness. They will also test the range of motion of the joint. This may include specialized manipulations of the joint, such as a Wilson test of the knee, to see if a particular rotation of the knee causes pain. To diagnose osteochondritis dissecans of the elbow, ankle or another joint, your child’s doctor will perform similar specialized manipulations.

Testing for osteochondritis dissecans

Various tests may be used to confirm the osteochondritis dissecans diagnosis.

  • X-rays: Typically, multiple x-ray views are taken to confirm and assess the extent of the injury. X-rays may also be taken of the same joint on the other limb as a basis for comparison.
  • MRI (magnetic resonance imaging): An MRI can show whether the loose piece is still in place or has moved into the joint space.

How is osteochondritis dissecans treated?

Your child may not need surgery if the loose piece of bone has not detached. They will need to take a break from high-impact sports while they heal. Their physician may recommend rest, ice, compression, and elevation (RICE), combined with non-steroidal anti-inflammatory medications for pain.

Surgical repair

Your child may need surgery if the OCD lesion is unstable, if a fragment of bone or cartilage has broken off into the joint, or if the injured area does not heal after a course of rest.

Your child’s doctor will select a surgical technique based on the type of osteochondritis dissecans, your child’s age, and other factors. Surgical procedures to repair osteochondritis dissecans of the knee or elbow include:

  • drilling small holes in the underlying bone to stimulate healing
  • removing or securing loose fragments of bone
  • a procedure called osteochondral autologous transplantation surgery (OATS)

Osteochondral autologous transplantation surgery (OATS)

OATS, or osteochondral autologous transplantation surgery, is a treatment option for certain OCD injuries. The procedure involves replacing injured bone and cartilage in the joint with healthy tissue taken from another part of the body, such as the side of the knee.

The OATS procedure repairs osteochondritis dissecans by replacing the injured bone and cartilage with healthy tissue taken from elsewhere in the body.What is the long-term outlook for osteochondritis dissecans?

After surgery, your child may need to wear a cast or brace while their joint heals. They may need to complete a course of physical therapy before gradually resuming activity or sports.

Your child should be able to return to sports and activities after their knee, elbow, or other joint has regained strength and stability — usually around six months after surgery. If your child’s joint remains painful or unstable after surgery and a period of recovery, their doctor may recommend lifestyle changes such as switching to low-impact sports.