Understanding The Broken Bone You Never Knew You Had
Osteochondritis dissecans (OCD) can sound alarming when you learn that a small piece of cartilage and bone can break off inside a joint, sometimes floating around and causing discomfort or pain.
While this condition most commonly affects adolescent boys involved in sports, anyone can experience it.
This guide covers its causes, symptoms, and how physical therapy and treatment can help restore strength and mobility.
What Is Osteochondritis Dissecans?
Osteochondritis dissecans occurs when a small piece of cartilage breaks off from the end of a bone, along with a sliver of the bone itself.
- This fragment may remain attached or move around within the joint, sometimes causing pain, stiffness, or even locking.
- The knee is the most common joint affected, but OCD can also occur in the ankle, elbow, or hip.
- Sometimes, this stray piece of bone does not cause any real symptoms, and the fracture may heal itself before it is even noticed.
When the condition becomes symptomatic, however, it can limit your ability to move the joint freely and participate in normal activities, including sports or daily routines.
Symptoms of Osteochondritis Dissecans
OCD symptoms vary based on the severity of the condition and the joint involved.
The most common signs include:
- Joint pain: Pain is often deep within the joint, worsening with physical activity such as walking or running.
- Swelling: Inflammation can develop around the joint over time, especially after increased activity.
- Stiffness: The joint may feel stiff after resting, making it harder to move or straighten.
- Popping or locking: You may hear or feel a “pop” or “click” as you move, particularly if the loose fragment gets caught in the joint. Sometimes the joint may even lock temporarily.
- Limited range of motion: As the condition progresses, it becomes harder to fully extend or bend the joint, which can affect daily activities and athletic performance.
Symptoms may range from mild discomfort to severe pain.
If the broken-off cartilage becomes trapped between a joint, or if the fracture begins to cause persistent pain or decreased motion, surgery may be necessary.
It’s important to consult a healthcare provider for an accurate diagnosis if you experience any of these issues.
Causes of Osteochondritis Dissecans
The exact cause of osteochondritis dissecans remains uncertain, but a few key factors contribute to its development.
1) Reduced Blood Flow to the Bone
OCD often occurs when blood flow to the end of the bone is compromised.
This lack of circulation weakens the bone tissue, causing a fragment of bone and cartilage to break away from the rest of the joint.
Without proper blood supply, the bone’s structure deteriorates.
2) Repetitive Stress on the Joint
OCD is common in adolescents involved in high-impact sports like soccer, basketball, or gymnastics.
Repeated stress or trauma to the joint, especially if there’s improper technique or overuse, can weaken the cartilage and underlying bone.
Over time, this stress makes the joint more susceptible to injury.
3) Genetic Predisposition
A family history of osteochondritis dissecans or other joint-related issues may increase the risk of developing the condition, suggesting that genetics can play a role.
Risk Factors
- Age: Osteochondritis dissecans typically affects young people between the ages of 10 and 20, particularly during periods of growth.
- Gender: Boys are more likely to develop OCD, although it can affect girls as well.
- Sports Participation: Active young athletes, especially those in sports with repetitive joint movements, are at a higher risk.
Diagnosing Osteochondritis Dissecans
If you’re experiencing joint pain, stiffness, or other symptoms of OCD, it’s important to seek medical attention.
Your physician will usually diagnose osteochondritis dissecans by performing a physical examination, along with imaging studies such as an MRI (magnetic resonance imaging).
1) Physical Examination
Your healthcare provider will check for tenderness, swelling, and range of motion by examining the joint and asking you to move it in specific ways.
This helps determine whether the joint is stiff or if there are any “locking” sensations.
2) Imaging Studies
To confirm the diagnosis, your doctor will likely recommend imaging tests, such as:
- X-rays: These provide a view of the bones and can reveal any fractures or loose fragments within the joint.
- MRI (Magnetic Resonance Imaging): An MRI offers a more detailed picture, showing the condition of the cartilage and whether the bone fragment has detached completely.
These images help assess the severity of the condition and guide treatment options.
Treatment Options for Osteochondritis Dissecans
The best treatment for osteochondritis dissecans depends on factors like the patient’s age, the location and size of the fragment, and the joint involved.
Treatment can be either nonsurgical or surgical.
Depending on the size of the fracture and its location, your physician will determine whether you need surgery or if nonsurgical treatment will be enough.
Nonsurgical Treatment
For mild cases where the fragment is still attached or symptoms are not severe, nonsurgical treatments are often recommended.
– Rest and Activity Modification
Resting the affected joint is crucial for healing. Your doctor will likely advise you to avoid activities that put stress on the joint, such as running, jumping, or playing sports.
In more severe cases, crutches may be recommended to reduce weight-bearing on the joint.
– Physical Therapy
Physical therapy is essential in regaining mobility and strength after osteochondritis dissecans.
Your physical therapist will guide you through strengthening, flexibility, and balance exercises designed to gradually restore movement and strength to the affected joint.
If surgery is needed, a longer, more intensive version of these therapeutic techniques will help get you on your feet as soon as possible.
– Pain Management
To manage pain and inflammation, treatments like ice therapy, electrical stimulation, or ultrasound therapy can be used to provide relief and aid recovery.
Surgical Treatment
Surgery may be required if nonsurgical methods do not resolve the issue or if the bone fragment has fully detached, causing pain and restricted movement.
- Arthroscopy: A minimally invasive procedure where a small camera is inserted into the joint to either remove or reattach the loose fragment.
- Drilling: In some cases, drilling into the bone stimulates blood flow and encourages healing.
- Bone Grafting: For more severe cases, bone grafts may be needed to replace the damaged bone.
After surgery, a rehabilitation program involving physical therapy is critical for a full recovery.
Recovery and Rehabilitation
Recovery from osteochondritis dissecans varies based on the severity of the condition and the treatment method.
Both surgical and nonsurgical patients need to follow a structured rehabilitation plan to regain strength, flexibility, and full range of motion.
Post-Treatment Physical Therapy
A tailored rehabilitation program helps restore joint health and prevent future injuries.
Your physical therapist may include:
- Range-of-motion exercises: Gentle stretches keep the joint flexible, reducing stiffness. These flexibility exercises help restore the joint’s natural movement, allowing you to return to daily activities without discomfort.
- Strengthening exercises: Strengthening the muscles around the joint offers better support and reduces strain. Focuses on muscles around the joint to prevent further injury and improve joint stability.
- Joint mobilization and balance training: These exercises restore proper joint movement and enhance stability, which is especially important for athletes.
Did you know you have Direct Access* to Physical Therapy? No referral, no problem!
Final Thoughts
Osteochondritis dissecans can sound intimidating, but with the right treatment plan and commitment to physical therapy, most patients make a full recovery.
Early diagnosis and prompt treatment play a significant role in getting back to normal activities.
If you’re experiencing joint pain or stiffness, don’t hesitate to seek medical advice—you can be back on your feet and active again with proper care.
The Jackson Clinics serves 18 locations throughout Northern Virginia.
Find one near you: https://thejacksonclinics.com/locations/