Osteochondritis Dissecans eMedicine Orthopedics

Description: Contents - Introduction Indications Relevant Anatomy And Contraindications Workup Treatment Complications Outcome And Prognosis Future And Controversies Pictures Bibliography
Synonyms and related keywords: OCD, osteochondral fragments, juvenile osteochondritis dissecans, adult osteochondritis dissecans, OCD of the knee, OCD of the elbow, OCD of the ankle, knee OCD, ankle OCD, lower extremity OCD, upper extremity OCD, elbow OCD, adult OCD, osteochondral loose bodies, elbow injury, knee injury, ankle injury, knee surgery, elbow surgery, ankle surgery
In OCD, a fragment of cartilage and subchondral bone separates from an articular surface. In 1840, Pare was first to describe the surgical removal of loose bodies, presumably osteochondral fragments, from joints. For many years, the treatment of choice for OCD remained either arthrotomy with removal of the loose osteochondral fragment or conservative, nonoperative management. The latter option remains the treatment of choice for patients with early disease and open physes. In contrast, surgical options have traditionally included drilling of the site of the defect, removing the loose body, fixing the loose body to the site of separation, and placing osteochondral grafts. Current operative methods include fixation of the lesion, drilling of the site of the defect with removal of loose bodies, and, most recently, autologous osteochondral mosaicplasty and autologous chondrocyte transplantation.