Author information: (1)Klinika za ortopediju Medicinskog fakulteta Sveucilista u Zagrebu, KBC Zagreb. Treatment for osteochondritis dissecans depends on when the problem is discovered. The chip fracture can vary in size and severity. In some cases the surgery can be done using an arthroscope. Two lesions were located on the joint surface of the distal tibia, a site not previously reported. The cause of Osteochondritis Dissecans is currently not known to the medical world but if not cured in time OCD can … If your surgeon used dissolvable stitches, these will not need to be removed. NIH It can also affect other joints, such as elbows and ankles. Osteochondral lesions are most common in the knee joint, and the ankle is the next most frequent joint affected. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. eCollection 2016 Apr. If osteochondritis dissecans is not recognized early, the bone fragment may not heal and may continue to cause problems. Thirty patients with osteochondritis dissecans of the ankle have been followed up for an average of 21 years. Bui-Mansfield LT, Kline M, Chew FS, Rogers LF, Lenchik L. AJR Am J Roentgenol. Orthop J Sports Med. Osteochondral lesions of the talus can be associated with injury to the ankle. Osteochondritis dissecans of the talus: long-term results of surgical treatment. You will be placed in a cast or cast boot during this period to protect the bones while they heal. Osteochondritis Dissecans takes place whenever a small bone segment starts to separate from its nearby region because of a lack of enough blood supply. Osteochondritis dissecans of the talus is a subset of osteochondral lesions of the talus that also includes osteochondral fractures, avascular necrosis, and degenerative arthritis. As a result, the small piece of bone and the cartilage covering it begin to crack and loosen. While the surgeon watches on a TV screen, the fragment can be removed and the defect drilled. Epub 2018 Apr 11. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. If discovered immediately after a twisting injury to the ankle, immobilization in a cast for six weeks may be suggested to see if the bone injury heals. Osteochondritis dissecans is a condition in which blood supply is cut off to the end of a bone, resulting in fragmentation of bone and cartilage in the joint. Osteochondritis dissecans (os-tee-o-kon-DRY-tis DIS-uh-kanz) is a joint condition in which bone underneath the cartilage of a joint dies due to lack of blood flow. Eventually this new scar tissue smoothes out the defect and allows the ankle to move more smoothly. 2000 Nov;175(5):1305-8. doi: 10.2214/ajr.175.5.1751305. This site needs JavaScript to work properly. J Bone Joint Surg Br. A long-term study. If your surgeon recommends nonsurgical care using a cast or cast boot, you may be on crutches for up to six weeks. However, if the articular cartilage is broken, bone chip fragments may move out of position hindering the healing process.  |  Osteochondritis dissecans is a loss of blood supply to a segment of bone and cartilage in the ankle and may result in a small fracture or collapse of the joint surface. Osteochondritis dissecans can affect all age groups and usually follows a twisting injury to the ankle such as an ankle sprain. OCD most often occurs in the knee joint, although it can also occur in other joints including the ankle and the elbow. Beil FT, Bruns J, Habermann CR, Rüther W, Niemeier A. J Am Podiatr Med Assoc. What Are the Signs & Symptoms of Osteochondritis Dissecans? When only one lesion occurs in a single joint, the condition is known as sporadic osteochondritis dissecans. It occurs more often in males. OCD is most common in the knee joint, but it can happen in other joints such as the elbow and ankle. Clin Sports Med. Purpose: To assess the demographics and epidemiology of OCD of the ankle in children. Osteochondral autograft transfer for post-traumatic osteochondral defects of the anterolateral surface of the distal tibial plafond. Osteochondritis dissecans causes pain in the affected joint. Clinical practice guidelines (CPG) provide evidence-based recommendations for current orthopaedic diagnostic, treatment, and postoperative procedures. The condition can be mild, moderate, or severe. Holes are drilled in this area allowing new blood vessels to grow and helping scar tissue to form to fill in the area. The articular cartilage on the talus is about one-eighth of an inch thick and allows the bones of the ankle joint to slide against each other without much friction. * A. In many cases of OCD in children, the affected bone and cartilage heal on their own, especially if a child is still growing. Study Design: Descriptive epidemiologic study. You will probably need crutches as well. Osteochondral lesion of the distal tibial plafond in an adolescent soccer player: a case report. San Jose, CA 95129, 1350 41st Ave 2020. HHS However, in some cases, Osteochondritis Dissecans takes … Osteochondritis dissecans in the ankle thus seems to differ from the same lesion in the knee where late osteoarthritis often occurs. Exercise usually makes the pain worse. Acta Orthop. Osteochondritis dissecans (OCD) is a problem that causes pain and stiffness of the ankle joint. Through other small incisions, special instruments can be inserted into the ankle. OCD lesions are also called osteochondritis dissecans or osteochondral fractures. When it becomes necrotic, the overlying cartilage is devitalized, and frequently the entire fragment separates out and forms an intra-articular loose body. Because the bone chip is separated from the rest of the talus, blood vessels traveling to the chipped fragment are torn and the blood supply to fragment is lost. You may need to keep weight off the foot and use crutches during this period of immobilization. This can occur in any joint, although it is most common in the knee, followed by the ankle, elbow, and shoulder. Lambers KTA, Dahmen J, Reilingh ML, van Bergen CJA, Stufkens SAS, Kerkhoffs GMMJ. The stitches will be removed 10 to 14 days from surgery. It occurs when a small segment of bone begins to separate from its surrounding region due to a lack of blood supply. Osteochondritis Dissecans (OCD) Talus/Tibia. Symptoms of Osteochondritis dissecans OLTs usually occurs after an injury to the ankle, either a single traumatic injury or as a result of repeated trauma. Osteochondritis dissecans usually develops in just one joint. Knee Surg Sports Traumatol Arthrosc. Most cases of OCD usually follow a twisting injury to the ankle and are actually fractures of the joint surface. In these cases, surgery may be necessary. Usually a small area of bone adjacent to the articulating surface is affected. Most cases of osteochondritis dissecans are caused by actual chip-type fractures . Surgery usually involves removing the loose fragment of cartilage and bone from the ankle joint and drilling small holes in the injured bone. OCD usually causes pain during and after sports. In some cases, you or your doctor will be able to feel a loose fragment inside your joint. Yabumoto H, Nakagawa Y, Yamada S, Mukai S, Mukaida S, Ninomiya S, Tsubouchi N, Matsuoka M, Tarumi E, Nakamura T. Trauma Case Rep. 2016 Jun 19;3:18-25. doi: 10.1016/j.tcr.2016.05.008. Osteochondritis dissecans typically affects just one joint, however, some children can develop osteochondritis dissecans … In grown children and young adults, OCD can have more severe effects. Osteochondritis dissecans can cause symptoms either after an injury to a joint or after several months of activity, especially high-impact activity such as jumping and running, that affects the joint. Osteochondritis Dissecans of the Ankle. Osteochondritis dissecans usually affects the knee at the end of the thighbone (femur), ankle and elbow. eCollection 2020 Jun. 2012 Jul-Aug;102(4):338-42. doi: 10.7547/1020338. The ankle is a small joint, and the arthroscope may have difficulty getting into certain areas of the joint. Elbow, ankle, and knee are the common joints affected due to Osteochondritis Dissecans. When it becomes necrotic, the overlying cartilage is devitalized, and frequently the entire fragment separates out and forms an intra-articular loose body. Common symptoms include prolonged pain, swelling, catching, and/or instability of the ankle joint. [Article in Croatian] Bojanić I(1), Cerovecki T, Smoljanović T, Ivković A, Trsek D, Borić I. The top of the talus is dome-shaped and is completely covered with cartilage (connective tissue that allows the ankle to move smoothly). Clinical Practice Guideline on the Diagnosis and Treatment of Osteochondritis Dissecans. When the fragment is removed, a defect shaped like a small crater is left in the talar dome . OCD is characterized by a loss of blood supply to one or more bones in the ankle, which may result in a fracture or break within the ankle joint. The OCD lesions have a greater chance of separating from the surrounding bone and cartilage, and can even detach and float around inside the joint. An arthroscope is a special miniature camera that can be inserted into the joint through a very small incision. 2020 Jan;28(1):141-147. doi: 10.1007/s00167-019-05687-w. Epub 2019 Sep 13. It usually takes 3 months or longer to heal completely. If the defect is difficult to reach with the arthroscope, an open incision may be required. You will probably wear a dressing for a week following the procedure. The name osteochondritis dissecans (OCD) is a misnomer. X-rays of your ankle will usually show a problem on the top of the talus (sometimes called the talar dome). B. Flick, M.D. Osteochondritis dissecans occurs most commonly in the knee, but also occurs in elbows, ankles and other joints. The surgery can be performed in several ways. Usually a small area of bone adjacent to the articulating surface is affected. The histories and radiographs were reviewed, and it was found that most patients had … Osteochondritis dissecans can affect all age groups and usually follows a twisting injury to the ankle such as an ankle sprain. Seo SG, Kim JS, Seo DK, Kim YK, Lee SH, Lee HS. 1991 May;73(3):461-4. doi: 10.1302/0301-620X.73B3.1670450. Long-term Prognosis After Successful Nonoperative Treatment of Osteochondral Lesions of the Talus: An Observational 14-Year Follow-up Study. Osteochondritis dissecans is a loss of blood supply to a segment of bone and cartilage in the ankle and may result in a small fracture or collapse of the joint surface. Osteochondritis dissecans (OCD) is a condition in which a fragment of bone and cartilage separates causing pain, swelling and mechanical issues. Your child has been diagnosed with osteochondritis dissecans (OCD).  |  You may feel swelling and pain and have difficulty placing weight on the ankle. Special tests such as computerized axial tomography (CAT scan), or magnetic resonance imaging (MRI) may be necessary to determine the full extent of the area involved. Articular cartilage is the white, slippery material that covers all joint surfaces. Epub 2017 Mar 11. Osteochondritis dissecans (OCD) is a condition that develops in joints, most often in children and adolescents. 340 Dardanelli LaneSuite 10 & 20Los Gatos, CA 95032, 50 E Main Street Suite AMorgan Hill, CA 95037, 1066 S Green Valley RdWatsonville, CA 95076, 1600 Saratoga Ave Osteochondritis Dissecans of the Talus (Transchondral Fractures of the Talus): Review of the Literature and New Surgical Approach for Medial Dome Lesions Show all authors . Methods: A retrospective chart review of an integrated health system was … 2017 Jul;36(3):469-487. doi: 10.1016/j.csm.2017.02.005. Most commonly, the knee is affected, but osteochondritis dissecans may occur in the elbow, ankle or hip as well. Please enable it to take advantage of the complete set of features! The top of the talus is part of the ankle joint and is covered with articular cartilage. This is caused by the chip getting caught in the ankle joint as it moves. 1989 Dec;10(3):161-3. doi: 10.1177/107110078901000309. If it heals completely, kids who have it usually don't have any long-lasting problems. J Can Chiropr Assoc. COVID-19 is an emerging, rapidly evolving situation. A physical therapist may help you learn to use your crutches. Osteochondritis dissecans is a localized injury or condition affecting a surface of the joint that involves a separation of a segment of cartilage and the underlying bone. Management of Osteochondritis Dissecans Lesions of the Knee, Elbow and Ankle. Osteochondritis dissecans is a condition that causes ankle pain and stiffness . This usually happens due to the lack of blood supply to the area. USA.gov. This condition occurs when a piece of the bone partially or fully separates from the end of the bone that forms a joint.  |  A 20-year Follow-Up Study - PubMed Thirty patients with osteochondritis dissecans of the ankle have been followed up for an average of 21 years. Osteochondritis dissecans includes symptoms similar to ankle sprain injuries. Of features hindering the healing process ankle sprains on multiple occasions is common it also... Characteristics and a generalized ache in the knee, elbow, ankle or as... The same lesion in the ankle thus seems to differ from the same lesion in knee... Need to keep weight off the foot and use crutches during this period to protect the bones and tissues... Feel a loose fragment inside your joint, Chew FS, Rogers LF, L.! Are the common joints affected due to the articulating surface is affected where late osteoarthritis often occurs in ankle! J, Habermann CR, Rüther W, Niemeier A. J Am Podiatr Med Assoc on multiple is. 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