I am an athletic, 6'3', 19 year old male, and have played sports all my life. I was diagnosed with OCD in my left knee on the medial side at the age of 15, but I can remember having pain that would come and go since I was 11. I learned to run with my bad knee and could perform at a high level in basketball and other sports as long as I didnt over-do it. In the summer between my junior and senior year in highschool, a fragment broke off in my left knee. The pain did not seem to be any worse than before but I needed surgery to remove the fragment. As if that wasn't disheartening enough, on the first day of my senior year I noticed a dull pain in my right knee as I was walking to class. The pain got progressively worse and upon visiting the doctor for xrays he found that I had the same issue on my right knee, in the same location. I ended up getting a scope on the left knee to remove the fragment and smooth over the bare spot left behind. I was on crutches for 6 weeks with little to no pain and the knee definitely felt better. Upon trying to return to normal activity, I quickly learned that my right knee, all the sudden, was my limiting factor. This was extremely frustrating and confusing to me because my right knee literally never experienced any pain until that first day of my senior year. I had to stop playing sports and ride the bike for exercise. Anyways, fastforward one and a half years and the problem in my right knee has not gotten better with conservative treatment. My gait is not strong and efficient like it used to be and I've lost a lot of my explosiveness and leverage. The way that I compensate when I run has caused me to develop ankle pain that I suspect is early signs of ankle OCD. I have made the decision to get surgery on my right knee and am trying to decide the best method. My fragment is still partially attached so I am leaning towards fixation with screws or pins. If any body has had this procedure, any other procedure, or has had any experience with this challenging condition, please talk to me.
By: : Apr, 15, 2013 13:24 PM
Thanks for the responses, I actually had my pre-op appointment this morning to discuss the upcoming surgery. Clinically (on the MRI), my OCD does not look very severe, in fact it does not look much different than the MRI from a year ago. Because of this and my young age, my doctor and I have decided to "not do anything too heroic" with the surgery. We want to avoid the possibility of making the problem worse by not affecting the surrounding cartilage. As for the actual procedure (arthroscopic), my doctor will decide what needs to be done once he is inside the knee, probing the defect. This may be fixation with pins, a small microfracture, or smoothing of the cartilage surface. I definitely do not want the problem to get worse so I am onboard with "conservative surgery."
By: manuel4md: Apr, 15, 2013 00:51 AM
After reading your blog, i researched a little on Osteochondritis Dissecans
and i found out it is more common than i initially thought. It is common on younger male that is active in sports and other physical recreational activities. From the sound of it is that your conservative management failed and congratulations for deciding to have the surgery. Here are some of my suggestions. 1) not all OS are the same, no matter what they say or you hear in the same manner that not all basketball players are the same and naturally we want the best one to handle our delicate knee. Consequences will be lifelong if done wrong. So seek expert consult to high volume centers that know what they are doing. You'll always be safer with them. 2) There is nothing wrong in getting 2nd opinion and ask plenty of questions that you can think of. The more you know and understand the better for you and for your OS and this would improve outcome of surgery.3) Go to a sports OS expert, someone that handles professional atheletes that way you know your in good hands. Try searching for Dr. Joseph Purita or Dr. Terry Grossman i read somewhere that they're able to treat conditions that is refractory to conventional treatment.
I hope this would help you and let us know what happens. Best of luck.
By: AllanW: Feb, 07, 2013 17:09 PM
Wow, that sounds awful. I hope somebody can help you out. I've never even heard of this condition before. Is it common? You'll have to let us know how it goes.
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