Level of evidence: A1. Impaired function, limited range of motion, stiffness, catching, locking an… , The initial stage should be focused on advice, education and pain management. Some post operative protocols state no strengthening exercises until three months. - Grasp the patient’s foot and bring the tibia in internelly rotation. Osteochondritis dissecans (OCD) most commonly affects the knee.  It can eventually lead to osteoarthritis and other elbow pathologies if not treated. (accessed 18 Oct 2016). Osteochondritis dissecans can involve the bone and cartilage of virtually any joint. The separated flakes can then ossify due to nourishment by the synovial fluid.The cartilage is damaged and can form a loose body. This fragment falls between the moving parts of the knee joint and blocks it. The smooth articular surface of the femur roll and slide on the tibia plateau. Bohndorf K. Osteochondritis (osteochondrosis) dissecans: a review and new MRI classification. In this procedure, stretching exercises are performed. Elbows and knees are most commonly affected. In case immobilization is insufficient, as would normally be the case for adults, a mobilization procedure must be started up. Evaluation and treatment of osteochondritis dissecans lesions of the knee.  For medical management, the use of arthroscopic surgery is the main route of management to remove the bony fragments. 1. , In some cases a large fragment may need to be re-attached to the capitellum which will be done via K wire or screw fixation. The goals of conservative therapy are: pain reduction, promote the repair of the cartilage and prevent degeneration of the surface of the knee joint. 1st ed. Osteochondral Defects In The Elbow Musculoskeletal Key The degree of injury ranges from a small crack to a piece of the bone breaking off inside the joint. Bohn Stafleu van Loghum. When pain has settled, management would be to gradually introduce full ROM and strengthening exercises out of a painful range. Osteochondritis dissecans of the capitellum.  That process can lead to pain, loose body formation and joint effusion. In the elbow, the most common area affected is the capitellum, although it has been reported to affect the olecranon and the trochlea. Using neuromuscular electrical stimulation to the quadriceps and hamstrings for coactivation contractions can further augment the strength maintenance program. Osteochondrosis dissecans. The separated flakes can then ossify due to nourishment by the synovial fluid. Level of evidence: A1. If there is no certain radiological determination of osteochondritis dissecans, there can also be alternative causes of the same symptoms that should be sought for e.g.:. Osteochondral autograft transplantation (OATS). The smooth articular surface of th… Diagnosis and treatment of osteochondritis dissecans. The femoral condyles (lateral and medial) which are the distal rounded ends of the femur, articulate with the proximal side of the tibia (tibia plateau). Level of evidence: A1, (2008). In a hinged brace set to pain free range of movement (ROM), Ceasing sports or activities that aggravate symptoms for 6-12 weeks, Mirco-fracture the site to stimulate increased blood flow. OCD occurs when one or more flakes of articular cartilage separates and forms loose bodies within the joint. , Main characteristics of the disease that are commonly mentioned are locking, giving away, stiffness and recurrent effusions. The first is located between the femur and tibia (art. De Graaff F, Krijnen MR, Poolman RW, Willems WJ Orthopaedics: the knee limited... He has developed persistent ankle pain associated with weightbearing left knee pain OCD. Determined based on Radiographic osteochondritis dissecans physiopedia 7 ] more frequently seen in males ( ages 10-14 than... 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