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Osteochondritis Dissecans (OCD) of the Knee in Children
Osteochondritis dissecans (OCD) is a condition where a segment of bone and overlying cartilage in the knee loses blood supply and can separate, creating a loose piece in the joint - it most commonly affects active children and adolescents aged 10-20 years in the thighbone just above the knee joint - juvenile OCD (in children with open growth plates) has better healing potential than adult OCD, with 50-60% healing with conservative treatment (activity restriction, protected weight-bearing for 3-6 months) - unstable or displaced fragments require surgery to drill the bone (stimulate healing) or fix the fragment back in place achieving 70-85% good outcomes.
đWhat is Osteochondritis Dissecans (OCD) of the Knee in Children?
Osteochondritis dissecans (OCD) is a condition where a segment of bone and overlying cartilage in the knee loses blood supply and can separate, creating a loose piece in the joint - it most commonly affects active children and adolescents aged 10-20 years in the thighbone just above the knee joint - juvenile OCD (in children with open growth plates) has better healing potential than adult OCD, with 50-60% healing with conservative treatment (activity restriction, protected weight-bearing for 3-6 months) - unstable or displaced fragments require surgery to drill the bone (stimulate healing) or fix the fragment back in place achieving 70-85% good outcomes.
đŦWhat Causes It?
- Repetitive microtrauma from sports (running, jumping) disrupting blood supply to bone segment
- Genetic predisposition (family history of OCD in some patients)
- Avascular necrosis (loss of blood supply) causing bone and cartilage death
- Abnormal ossification (bone development) during adolescent growth spurt
- Biomechanical factors (knee alignment abnormalities increasing stress on specific area)
â ī¸Risk Factors
You may be at higher risk if:
- Age 10-20 years (peak incidence during rapid skeletal growth)
- Male gender (slight male predominance, approximately 2:1 ratio)
- High-impact sports (gymnastics, basketball, soccer, running)
- Family history of OCD (genetic component in some cases)
- Bilateral involvement (20-30% have OCD in both knees)
đĄī¸Prevention
- âAvoid sports specialization and year-round single-sport training in young athletes
- âCross-training with low-impact activities (swimming, cycling) reducing repetitive stress
- âAdequate rest and recovery between high-impact activities
- âEarly evaluation of persistent knee pain (early diagnosis improves outcomes)
- âAccept that many OCD cases occur spontaneously without clear preventable cause