A decision to progress each patient to the next phase should be … Surgery is usually the only effective treatment for OCD. Usually, the donor site for this procedure is on the joint surface of the injured knee. Even with surgery, OCD usually leads to future joint problems, including degenerative arthritis and osteoarthritis. A joint surface damaged by OCD doesn’t heal naturally. Medical Website Design by PBHS © 2020 • Non-Discrimination Notice, Orthopedic Surgeon Paul Kiritsis Treats Injuries and Disorders of the Shoulder and Knee in Midlothian VA, ACL Reconstruction with Hamstring Autograft, ACL Reconstruction with Patellar Tendon Autograft, Glucosamine and Chondroitin Sulfate for Osteoarthritis of the Knee, Viscosupplementation for Osteoarthritis of the Knee, Post-Operative Instructions: Shoulder Surgery, Post-Operative Instructions: Knee Surgery, A Patient’s Guide to Osteoarthritis of the Knee, A Patient’s Guide to Articular Cartilage Problems of the Knee. With the exception of arthroscopic removal of a loose body, patients are instructed to avoid putting too much weight on their foot when standing or walking for up to six weeks. How does Dr. Kiritsis treat the condition? Very rarely it affects articula… Dr. Kiritsis may want to reevaluate the knee and may suggest additional tests if your symptoms change. Osteochondritis Dissecans (OCD) of the Knee Dr. David Geier is an orthopedic surgeon and sports medicine specialist in Charleston, South Carolina. With this machine, we are able to create pictures that look like slices of the knee and see the anatomy, and any injuries, very clearly. OCD is a type of osteochondrosis in which a lesion has formed within the cartilage layer itself, giving rise to secondary inflammation. In some cases, Dr. Kiritsis will be able to use the arthroscope to do the surgery. This technology looks promising for treating JOCD and OCD but is still very much experimental. Call Paul Kiritsis, MD Phone Number 804-379-2414 with any questions or to make an appointment. Even with the treatment, some patients continue to have symptoms or their bone scans show signs that the damage is getting worse. A lesion of the cartilage and bone due to necrosis and loss of continuity of the underlying bone. In the adult, the bones are not growing. You may be asked to walk, move, or stretch your knee. Learning about OCD can not only put your mind at ease about you or your child’s treatment, but it can also help you make an informed decision. Open surgery usually requires larger incisions than arthroscopic surgery to allow the Dr. Kiritsis to see into the knee and perform the operation. The therapist will continue to be a resource, but you will be in charge of doing your exercises as part of an ongoing home program. Osteochondritis dissecans (OCD) is a problem that affects the knee, mostly at the end of the big bone of the thigh (the femur). Dr. Kiritsis will have you work with a physical therapist for four to six to twelve weeks. The MRI machine uses magnetic waves rather than X-rays to show the soft tissues of the body. Once the cartilage and/or bone breaks free, you will probably feel clicking, catching, or even locking of your knee. When this happens, JOCD develops into OCD. In this case, bone material is transplanted into the hole left in the bone. This gives the area time to heal. Many cases of JOCD can be completely healed with careful treatment. To know more please visit http://www.hanyelrashidymd.com/ How does Dr. Kiritsis identify this problem? The aforementioned 2012 study in The Journal of Bone and Joint Surgery assessed the clinical outcomes of these five different surgical techniques in patients affected by OCD of the knee… But they can be very successful in returning function to the knee. Osteochondritis dissecans (OCD) is a problem that affects the knee, mostly at the end of the big bone of the thigh (the femur). Look for information on OCD, different OCD, cases & research on OCD. This is one cause of degenerative arthritis and osteoarthritis. As the program evolves, more challenging exercises are chosen to safely advance the knee’s strength and function. OCD is most common in the knee joint, but it can happen in other joints such as the elbow and ankle. In some cases the dead area of bone may actually become detached from the rest of the femur, forming what is called a loose body. The savviest of surgeons will take into consideration the age of the child, activity level and the radiographic findings. I have just had surgery to treat OCD (osteochondritis dissecans) of my left knee. Dr. Kiritsis may use tiny metal pins or screws to hold the fragment in place. When these treatments work, the knee seems as good as new, and the JOCD doesn’t seem to lead to arthritis. For this reason, the treatment and prognosis of OCD and JOCD can be very different. Nonsurgical treatment of JOCD can take from 10 to 18 months. Osteochondritis Dissecans Knee | Knee Specialist | Minnesota It occurs when a small segment of bone begins to crack and separate from its surrounding region due to a lack of blood supply. Even with surgery, OCD often requires a long period of rest from sports to allow for healing. You may be advised to avoid heavy sport or work activities for up to eight weeks. The goal of nonsurgical rehabilitation is to help you learn ways to protect the injured area of cartilage while improving knee motion and strength. Dr. Kiritsis will have his patients take part in formal physical therapy after knee surgery for osteochondritis lesions. The area of bone just under the cartilage surface is injured, leading to damage to the blood vessels of the bone. This video demonstrates the treatment of an unstable osteochondritis dissecans (OCD) lesion of the knee. In the world of childhood knee injuries and complaints, there are few mysteries that still persist. An allograft is an actual transplant of bone and cartilage from a donor into your knee. Related Document: A Patient’s Guide to Knee Anatomy. When these problems develop, your Dr. Kiritsis may suggest surgery. If I have an OCD of my knee, what is the chance that I will have an OCD of another joint? The doctor says I have a 19mm indentation on the weight bearing portion of my knee. Dr. Kiritsis has seen excellent results with this surgery and has seen many athletes return to their pre-injury level of activity. In the elbow, it affects the capitellum of the humerus and, in the ankle, it affects the talar dome. These tests are important because Dr. Kiritsis needs to know the exact location and the size of the lesion to determine what kind of surgery will work best. The leading thought as to why knee OCD happens relates to the thin layer of growth cartilage that caps the end of long bones, such as the femur or thigh bone. Moving the knee becomes painful, and it may be swollen and sore to the touch. If the lesion becomes totally or partially detached, surgery is needed to remove the loose body or to fix it in place. OCD of the knee is thought to be bilateral, or in both knees, about 1 out of 4 times. The damage to the joint surface affects the way that the joint works. This may require additional X-rays, or MRIs. At first, emphasis is placed on exercising the knee in positions and movements that don’t strain the healing part of the cartilage. The authors' preferred treatment algorithm for osteochondritis dissecans (OCD) of the knee is based on skeletal maturity, OCD lesion stability, and OCD lesion salvageability. Even in JOCD, surgery may eventually be required. Osteochondritis dissecans (OCD) is an abnormality in the development of bone from cartilage. Share on Pinterest OCD can cause pain and discomfort in the knee and other joints. Eventually, there is too much pain to put full weight on that knee. Most areas of scientific inquiry concerning the knee revolve around the major ligaments and our knowledge of these injuries is so far advanced that often the remaining questions are minor fine-tuning. Even if imaging tests show that growth has already stopped, it is usually worth trying nonsurgical treatments. The leading thought as to why knee OCD happens relates to the thin layer of growth cartilage that caps the end of long bones, such as the femur or thigh bone. Exercises are chosen to help improve knee motion and to get the muscles toned and active again. When, for example, repetitive trauma results in a blood supply injury or blunt injury to this growth cartilage, then the bone can either fail to develop from the original cartilage, or the maturing bone dies, softens and collapses. Patient Question: My 13 year old son has been diagnosed with OCD of the patella, although I am very confused as to what this means. A joint surface damaged by OCD doesn’t heal naturally. If OCD of the knee is suspected, AP, lateral, notch-view (knee in flexion) and skyline patella xrays should be ordered. The condition can be mild, moderate, or severe. For unstabl … There are a number of treatment options. Download a Guide to our Knee-Saving Procedures. If you have surgery, Dr. Kiritsis may have you use a continuous passive motion (CPM) machine after surgery to help the knee begin to move and to alleviate joint stiffness. Could you please tell me how long the recovery time would be for the surgery because … Treatments & Surgery. Osteochondritis dissecans (OCD) is a disease that originates in the subchondral bone that affects the articular cartilage. See osteochondritis dissecans article for a general discussion. Dr. Kiritsis will order an X-ray of your knee. As knee symptoms ease, exercises can be started that don’t involve placing weight through your foot. The first few physical therapy treatments are designed to help control the pain and swelling from the surgery. Patients are strongly advised to follow the recommendations about how much weight is safe. You will also be shown strengthening exercises for the hip and knee to help steady the knee and give it additional protection from shock and stress. Recovery and surgery for an OCD lesion of the knee. Many doctors think that JOCD is caused by repeated stress to the bone. The American Academy of Orthopaedic Surgeons (AAOS) approved this clinical practice guideline on December 4, 2010. OCD and JOCD cause the same kind of damage to the knee, but they are separate diseases. A new technology called autologous chondrocyte implantation is currently being developed. The highest rates of OCD appear among patients between 10 and 15 years old, ranking among the most common causes of knee pain and dysfunction in teenagers.5,30,35 The prevalence of OCD is estimated at 15 to 21 per 100 000.27 Lesions most fre-quently occur … OCD is most common in people between the ages of 10 ... was trained at Harvard University in internal medicine and orthopaedic surgery and at Stanford University in general surgery. Some patients who are too near the end of bone growth may not benefit with nonsurgical treatment. The goal is to help the lesions heal before growth stops in the thighbone. Physical therapists will also work with patients to make sure they are only putting a safe amount of weight on the affected leg. In some cases, other muscle or bone problems can cause extra stress and contribute to JOCD. i just had surgery on my knee for ocd mine is 2.9cm by 1.8cm the doctor made the same cuts to my knee 2 small ones and one big one half way down my knee its like 2inches long. The bone is usually obtained from a bone and tissue bank. Doing exercises in a pool can help you stay limber and fit while protecting the knee during this period. If the loose bone fragment is in a weight-bearing area of your bone, Dr. Kiritsis may try to reattach it if possible. For unstable yet salvageable OCD lesions, the senior author's preferred treatment is fixation with bone grafting. The risk with an OCD is that the compromised segment of bone and cartilage may come loose, break away from the femur and float around inside the joint. In the child who is still growing, the problem is much more likely to heal itself. Children with the better prognosis can be treated conservatively at first. My doctor preformed the OATS (osteoarticular transfer system) procedure on July 1st. Mild OCD: A piece of bone has begun to separate from the joint, but this piece is still firmly held in place by a covering of cartilage (dense elastic tissue that helps cushion the joint). knee (most common) ... World Series of Surgery OCD Lesion: Diagnosis, Evaluation and Management - Geoffrey Van Thiel, MD (CSMS #45, 2018) Knee & Sports - Osteochondritis Dissecans A … This area of dead bone can be seen on an X-ray and is sometimes referred to as the osteochondritis lesion. This requires a period of activity modification and even bracing or casting during this rest period. Midlothian Orthopedic Surgeon, Dr. Paul Kiritsis, is dedicated to providing you with a pleasant visit. The exercises should be done carefully and should not cause any pain. This means stopping exercise and sports. 1. Posted December 15, 2008. The OCD lesion can remain in contact with the adjacent bone, maybe partially separated or completely separated. And the bone around the fragment has often changed in ways that mean Dr. Kiritsis will need to rebuild it. OCD Lesion – Knee Arthroscopy with Cartilage Repair and Regeneration. As the condition becomes worse, the area of bone that is affected may collapse, causing a notch to form in the smooth joint surface. This guide will help you understand 1. where in the knee the condition develops 2. how doctors diagnose the problem 3. what treatment options are available © 2020 Rady Children's Hospital–San Diego, OCD of the Knee May Require Rest or Surgery, COVID-19 Updates: Latest Information for Parents. The younger the patient and the smaller more stable appearing the OCD, the better the outcome and prognosis to heal. The therapist’s goal is to help you keep your pain under control, ensure safe weight bearing, and improve your strength and range of motion. 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