What is the treatment for OCD of the knee?
Treatment for this type of knee injury or defect will vary, based on the patient’s activity level and on the size, location and amount of damage caused by the defect.
The goal of conservative treatment is to reduce pain associated with the OCD defect. The mainstays of nonoperative treatment are rest, activity modification, bracing, physical therapy and non-steroidal anti-inflammatory medication, such as ibuprofen or naproxen. Younger patients (skeletally immature) may experience a resolution of symptoms after the knee growth plates have closed.
Surgical treatment for osteochondritis dissecans lesions is necessary if the lesion continues to be painful despite conservative treatment or if the lesion detaches from the knee condyle or patella. Dr. Williams may need to repair or remove the detached fragment. He can gain understanding of the necessary surgery by first using an arthroscope, which is a very small camera, inserted into the knee. He then uses small, specialized instruments to perform the surgery within the knee. Treatments may include:
- Arthroscopic knee debridement will remove loose bodies in the knee and can smooth down rough or torn tissue.
- Pinning of the OCD fragment involves stabilizing the loose OCD fragment with pins or screws to promote healing of the affected area
- Autograft osteochondral transplant (mosaicplasty)
- Allograft transplant obtained from a donor or cadaver can replace damaged cartilage tissue.
- Osteochondral autograft uses tissue obtained from the patient to restore the damaged bone and cartilage.
- Autologous chondrocyte implantation uses the bodies own cartilage cells, which are removed, grown in a lab, and implanted in the knee. The new cartilage that is grown from the cells is used as a patch replace the damaged area.
- Particulate juvenile articular cartilage obtained from donors can be used to regrow missing cartilage due to a detached OCD lesion
- MACI – Matrix Associated Autologous Chondrocyte Implantation
- Stem Cell Therapy
Patients should not bear weight on the injured knee after surgery. Physical therapy, strengthening exercises or a continuous passive motion machine, which is a machine that gently moves your joint to prevent stiffness, may be required.