- Osteochondritis dissecans (OCD) is defined as an area of osteonecrosis in subchondral bone that supports overlying cartilage.
- If the patient's growth plates are still open, the lesion is considered juvenile OCD (JOCD) and has a better prognosis for healing than adult OCD, where the growth plates are closed.
- Separation of cartilage from the underlying necrotic subchondral bone may result in a stable or unstable fragment of bone with attached overlying cartilage in the knee.
- OCD is caused by many factors including genetics, ischemia, altered local growth, inflammation, ossification, and repetitive microtrauma of the joint. It may also be idiopathic.
- Prevalence is 15-29 cases of OCD per 100 000 people.
- Most frequently seen in patients aged 10-19 years.
- Males are at 4 times increased risk compared to females.
- 69% of cases involve the lateral aspect of medial femoral condyle.
- 15% of cases involve the weight-bearing portion of the lateral femoral condyle.
- Active in sports
- Black race or Hispanic or Asian descent
Intraoperative Clanton and DeLee grading system:
- Grade 1 – normal articular cartilage
- Grade 2 – fragmentation in situ
- Grade 3 – partial detachment
- Grade 4 – complete detachment, loose body present