What is Osteochondritis Dissecans (OCD) – Femur and Patella
Osteochondritis dissecans (OCD) of the femur (more common) or patella (less likely) is a knee joint condition in which a small area of bone just beneath the cartilage loses blood supply, weakening and potentially causing it to separate. It most commonly affects the knee, elbow, and ankle. OCD most often affects children and adolescents, especially those who participate in high impact activities. It is significantly more common in males. Lesions in younger patients whose bones are still growing have a more favorable prognosis.
Causes
The exact cause of OCD is not fully known, but several factors can contribute. Repetitive stress on the knee joint, particularly from high-impact sports like hockey, soccer, or basketball, is a common trigger. A single injury or direct trauma to the knee can also exacerbate a developing lesion. Children and adolescents are more vulnerable because their bones are still growing, and areas with reduced blood supply may be more prone to weakening.
Symptoms
Symptoms include persistent knee pain, intermittent swelling, and a reduced range of motion. Some people may feel that the knee “gives out,” or experience locking, catching, or popping sensations. Pain often worsens with activity, especially during sports or high-impact movements.
Diagnosis
To diagnose OCD of the femur or patella, your medical history will be gathered, and a series of physical exam maneuvers will be completed to check for joint swelling and pain. An X-ray and/or MRI may be ordered to assess for bony edema, visualization of injury fragments, and characterize the severity of the OCD lesion.
Treatment
Treatment depends on the size, stability, and location of the lesion, as well as the patient’s age and skeletal maturity.
For smaller, stable lesions with open growth plates, a non-operative approach is often recommended. Patients will go through a phase of immobilization for around 4-6 weeks, followed by a gradual increase in physical activity and weight-bearing status. Concurrent physical therapy will help to increase the strength of the surrounding muscles.
For patients with unstable, detached, or larger lesions, or those whose growth plates have closed, surgery is often necessary. Common surgical techniques include drilling to allow increased blood flow to stimulate healing or internal fixation to reattach loose fragments. Recovery after surgery generally takes several months, with most patients gradually returning to full activities over 4–6 months, depending on the procedure and rehabilitation progress.