Osteochondritis Dissecans

What Is Osteochondritis Dissecans?

Osteochondritis dissecans (oss-tee-oh-kon-DRITE-iss DISS-ih-kanz) is when a piece of bone and the attached break down and become loose. The loose piece can break away completely from the end of the bone.

Osteochondritis dissecans happens most often in the knee, elbow, or ankle. It usually takes 3 months or longer to heal completely. If it heals completely, kids who have it usually don't have any long-lasting problems.

What Are the Signs & Symptoms of Osteochondritis Dissecans?

Osteochondritis dissecans causes pain in the affected joint. Exercise usually makes the pain worse. 

If it's not treated, the condition can lead to pain, swelling, catching or locking of the joint, and possibly arthritis.

What Causes Osteochondritis Dissecans?

Doctors aren't sure what causes osteochondritis dissecans. It may be from:

• a loss of blood supply to the bone
• repeated stress on the bone from sports or other activity
• some other process

Because osteochondritis dissecans can run in families, there may be a genetic link.

Who Gets Osteochondritis Dissecans?

Most cases of osteochondritis dissecans are in kids and teens 10 to 20 years old. Less often, adults get it, and they may have had it since they were young.

The condition usually happens in kids who are very active, such as those active in sports like gymnastics, baseball, and soccer. It also happens in people whose bones are not straight — for example, those with bow legs or knock knees.

How Is Osteochondritis Dissecans Diagnosed?

To diagnose osteochondritis dissecans, health care providers:

• ask about sports and activities
• do an exam
• get an X-ray and, sometimes, an MRI

How Is Osteochondritis Dissecans Treated?

Osteochondritis dissecans treatment includes:

• Rest. At first, this usually means complete rest and no weight bearing at all. Then, light daily life activities and weight bearing, as tolerated, can be introduced slowly. A cast, splint, or brace might be worn to keep the joint still.
• Avoiding any motion that causes pain.
• Taking time off from sports and other intense activities.
• Physical therapy (PT) to help with flexibility and strength.

Surgery may be recommended:

• if there is no improvement after rest and PT
• if a piece of the bone breaks away completely
• to fix a problem that is causing osteochondritis dissecans (such as bow legs or knock knees)

For pain, kids can:

• Put ice or a cold pack on the area every 1–2 hours for 15 minutes at a time. Put a thin towel between the ice and the skin to protect it from the cold.
• Take pain medicine as recommended by the doctor.

When Can Kids With Osteochondritis Dissecans Go Back to Sports?

Kids with osteochondritis dissecans usually need at least a few months off from sports. Kids who had surgery will need more time to heal. Returning to sports too soon can lead to long-term pain and joint problems.

Kids should only go back to sports if they:

• do not have pain in the area
• do not have any trouble doing everyday activities
• have followed their doctor's recommendations for resting the joint and PT
• have been cleared for sports by their doctor

How Can Parents Help?

Kids with osteochondritis dissecans heal best when they:

• Go to all follow-up doctor visits.
• Follow the recommendations for rest and PT.
• Don't go back to sports until the doctor says it's OK.

After kids go back to sports, they should:

• Use proper playing and safety techniques for each sport.
• If playing baseball, follow the pitching guidelines.
• Vary the sports they play. That way, one joint does not get overused.
• Stop playing right away if something hurts during training or a game. If the pain continues, they need to get checked by a coach, trainer, or health care provider before going back to sports.