Osteochondral defects (OCD)

  • OCDs are reported to occur inĀ 15 to 30 per 100,000 people
  • They are focal areas where the bone becomes soft and cannot support the cartilage layer of the joint surface directly above the bone
  • If small they may heal on their own without treatment
  • This is believed to happen in about 50-60% of cases only and can take 2 or even 3 years to heal
  • If large and over 15mm across they are very unlikely to heal
  • The cartilage layer must be protected to avoid it splitting or worse tearing off completely
  • Once an OCD is known about, if it is on a direct weight bearing surface of the joint, impact is best avoided to prevent the cartilage being injured as the body does not replace joint surface cartilage itself. This means no running, jumping etc
  • MRI scans are used to diagnose and monitor the progress of OCDs
  • If no healing is seen after 6 or 12 months then treatment can be considered
  • An arthroscopy under general anaesthetic is performed
  • If the joint surface is still in tact, the bone can be drilled and grafted from underneath to help it to heal
  • If the cartilage is split then it can be drilled directly to try and encourage healing
  • If the cartilage is loose then it must be removed and the base cleared to try and stimulate healing
  • A new substance called Chondrotissue is available to help grow better quality replacement joint surface
  • Stem cells are used in some centres but the costs are very high and funding is being withdrawn in many areas.

This is quite a complex subject and Mr Uglow will be happy to explain the exact situation in your knee if you have an OCD and the treatment options available to you