Osteochondritis Dissecans

Inside every joint, smooth cartilage covers the ends of bones, allowing them to glide easily against each other. In osteochondritis dissecans, a section of the bone under that cartilage loses its blood supply and dies. This causes the bone to become weak and separate from the cartilage. In some cases, the loose piece of bone and cartilage can break off completely and float inside the joint.

This condition most often affects the knee joint, but it can also occur in the ankle or elbow—especially in young athletes who play sports that involve running, jumping, or twisting movements. OCD can range from mild irritation to more serious damage that requires medical treatment to prevent long-term joint problems.

Symptoms depend on how severe the injury is and whether the bone fragment is still attached or has become loose. At first, symptoms may be mild and easy to overlook, but they can worsen over time.

Common symptoms include:

• A dull, aching pain in the joint—especially after physical activity.
• Swelling or tenderness around the knee.
• A feeling that the joint is “catching” or “locking” during movement.
• A sensation that the knee is weak or unstable.
• Trouble bending or straightening the joint fully.

If a loose fragment of bone or cartilage is floating in the joint, patients may also notice grinding, clicking, or even the joint getting stuck temporarily. These symptoms often come and go but ignoring them can make the condition worse.

The exact cause of osteochondritis dissecans isn’t always clear, but doctors believe it results from repeated small injuries to the bone beneath the cartilage. These micro-injuries can reduce blood flow to the bone, leading to weakening over time.

Some of the most common causes and contributing factors include:

• Repetitive stress: High-impact activities like basketball, soccer, or gymnastics place repeated pressure on the joints.
• Growth and development: During teenage years, rapid bone growth can make certain areas more vulnerable to injury.
• Joint injury: A fall, twist, or previous joint injury can increase the risk.
• Genetic factors: In some families, osteochondritis dissecans may occur more often, suggesting a possible hereditary link.
• Vascular issues: A naturally reduced blood supply to certain areas of bone can make them more prone to this condition.

Osteochondritis dissecans most commonly affects children, teens, and young adults who are active in sports such as basketball, soccer, baseball, or gymnastics. The knees take on significant stress during running, jumping, and pivoting—making them the most frequent site for OCD.

Adults can also develop osteochondritis dissecans, especially if they have a history of repetitive joint stress or untreated joint injuries. However, because adult bones have less healing potential than children’s bones, the condition tends to be more serious when it occurs later in life.

Dr. Collon will inquire about your symptoms and when they began, he will perform begin a physical exam to check for tenderness, swelling, and range of motion. Imaging tests such as X-rays and MRI scans are then used to confirm the diagnosis.

• X-rays show any bone irregularities or loose fragments.
• MRI scans give a detailed look at both the bone and cartilage, helping to determine whether the affected area is stable or unstable.
• CT scans may occasionally be ordered for more precise views, especially before surgery.

Getting an early diagnosis is key. Stable lesions in children and teenagers often heal with rest and activity modification, while unstable or detached fragments may require surgery to repair the damage.