Osteocondritis Dissecans Pain (Non-surgical)

[Kathryn Brooks]

I'm a adolescent, female who was diagnosed with Osteocondritis Dissecans in my left knee in 2009 after a bad fall at soccer and my specialist recommended 6 months rest at the time. As an active kid playing basketball and doing athletics (Javelin) he believed that it would heal on its own over time. (Stopped playing soccer all together!) Over the years I have spent more time on the sidelines watching because of my knee then doing what I love and playing and training, please help!?

That was all fine and it 'healed' really well and was back playing sport but it has never really felt right.... Been back to see him multiple times over the past few years and he continues to erasure me that the area is reducing in size and that there is nothing he can do.

In January of 2013, I was doing a lot of basketball and Javelin and playing soccer with school (reluctantly!). My knee began to play up and I went back to see him, but again reassured my that everything was fine.after multiple physio sessions, it began to feel a little better and I continued to play sport.

Recently my Javelin coach has been doing strength work on my quads, hips and calves but my knee still doesn't feel right! Sometimes it feels like it wants to collapse and I have been unable to climb stairs propably in years.

Has anyone got any tips on what I can do?? I am getting really desperate as it is starting to effect my sport and am unable to do simple activities like a simple quad stretch because it hurts my knee too much. Plates help with any tips on what I can try!! Thanks

[Tighe Crovetti]

Kathryn, I was diagnosed with an OCD lesion as a teenager as well. My understanding, OCD is when the blood supply is compromised, and the bone starts to die/soften/dry up (i.e., "dessicans - dessicate, dry out"). I have been through several procedures related to it. I had several ups and downs along the way, so I feel your frustration.

I did not think OCD could heal on its own, they went in surgically to fix mine (by putting "sponge-like" pins through the area, to draw blood in). X-rays showed lines of bone forming, and ultimately, my area almost completely filled in. However, my injury came with a cartilage tear as well, and that's what I've been dealing with. Your inability to stretch your quad or walk stairs, reeks to me of cartilage damage. I would be sure your doctor has examined that aspect thoroughly.

As for your prognosis, I'm going to have good news and bad news. The bad news is, "impact" sports are going to be hell on you. For me, it was basketball: a hard floor, a lot of sudden stop/start/cuts...it will kill you. I had to eventually give it up, even on a recreational basis, it's just too much. Here's good news: I believe you can help yourself a lot with PROPER leg work. Work your quads and entire core/posterior chain, but do it properly. In a lot of Crossfit, you'll hear, "weight on your heels" - getting your weight on your toes will hurt your knees. PROPER strengthening on your legs will help tremendously.

Overall, I think your issue is more cartilage-related. Get that sorted out. When that's cleared, see what the prognosis is for your OCD lesion filling in, which may just be more rest? After that, you may need to tweak your permissible activities, I know, and I'm sorry if that means giving up something you love, but I think you can definitely still be active via other sports, and your knee will hold up well.

[Kathryn Brooks]

Thank you for this information, I forgot to add that over the years he has done 3 MRI's to check the cartilage and they all returned the same message, that the cartilage was intacted but the bone was still damaged. He just said that the pain was due to lack of strength, but after 4-5 years of physio and strengthening you would think this would have fixed it self.

[Tighe Crovetti]

What do your latest x-rays say about the bone lesion itself? Is it filling in? We think a doctor saw my lesion a few years before my traumatic injury, and he chalked it up to, it was a 'growth plate' issue or such, and would just work itself out. It sounds like your doctors are saying the same thing, that you'll just grow and the area will repair itself, but are they specifically monitoring to see if that's happening? I can imagine if the bone is not healing, then you're going to continue to have strength issues, the actual strength of your leg muscles notwithstanding.

[Kathryn Brooks]

Well, I'm 16 and was diagnosed when I was 12, and my knee has continued to play up multiple times over the years after initially taking 12 months off sport. Last MRI showed that lesion was filling in but still there. (Originally size of 20cent AUS coin, now just over half the size)


I last saw my doctor in February of this year, and he only said to come back to see him if my knee locked or I had serious swelling....

He is meant to be one of the top orthopedic surgeons in Australia, so I trust him, so don't really know what to try next?

[Kathryn Brooks]

So just a quick update on this thread as I know that there isn't a lot of information out there about OCD and even fewer personal stories to help people out. So this ended up being a surgical case, more than 2 years after the original post was made I was continuing to have persistent locking and grabbing episodes that were worsening rapidly. I couldn't sit down without a 95% chance of my knee locking and me being in excruciating pain! I had surgery in May of 2015 to repair a lesion of bone which had almost completed broken off (like a flap of bone, about 1.5cm x 1.5cm big!) They put 5 dissolvable Yu pins through the bone to hold it in place, wasn't allowed to load the knee up at all for 6 months (no squats, no lifts, no running etc.) but was able to make a smooth transition back into running, sport and crossfit with no issues!! Although that wasn't the end of the story!

10 months post surgery, (March, 2016) not one but two of the pins failed and came loose with no explanation! The first had completed pushed its way out of the bone and the other was about half way out. Can someone please explain to me how this happens?!? From what I had been told before the first surgery and also further research since, this simply shouldn't happen as then bone should be almost completed healed by 10 months!! It was the first time my surgeon had seen it, and he was baffled as to why it had occurred so he simply just removed the 2 pins as he didn't really know what else to do even after consulting with another Orthopedic surgeon to discuss the best method! Two days after the pains simultaneously failed, I was rushed into surgery as my knee had completed locked up and the pain was excruciating!

I was told that I would be back to running in about 6 weeks and back to full training in 8! BUT again the story didn't finish there! Persistent pain and swelling in my knee, no matter how long I take off or how slowly I come back I have had partial grabbing through the lateral side of my knee, pain through the medial back of my knee and other aching pains. Some days I am completed fine, others I can't walk and some I can't even straighten or bend my knee.i have had further MRI scans which didn't show anything that related to my various symptoms! Opinions from 2 surgeons, 3 sports docs, 8 physios and sports psychologist and numerous hours spent searching the Internet for answers I still don't have no idea!

It has now been 7 years of dealing with OCD and it seems like the aftermath is still going! If anyone has any suggestions or similar experiences please let me know as I am seriously running out of ideas other than to just give up on sport and crossfit!

Hopefully sharing my experience of OCD can help someone else out! Thanks

[Sean Rockett]

so do they see any irregularity on the MRI at the previous site. It sounds like the previous site may be the issue. When it locked was there a loose piece of bone or pin floating in there?

[Kathryn Brooks]

Originally Posted by Sean Rockett

so do they see any irregularity on the MRI at the previous site. It sounds like the previous site may be the issue. When it locked was there a loose piece of bone or pin floating in there?

Thankfully I am finally painfree! The cause of the locking was due to the pin coming loose and jamming the join up, and was immediately solved by the surgery in March of 2016. But I was left with the severe grabbing pain on the lateral side. After a further 5 months of complete rest (what it took for complete swelling to dissipate) I was finally able to start getting back into training in January of this year (2017), almost 8 months after the surgery!

To answer your question about the scans I had post surgery.. it's a little complicated but I didn't actually see the MRI report for almost 6 months after the scans (for various reasons) but here goes... "There is a 20mm x 10mm area of overlaying cartilage (on the medial femoral condyle where the pins were) that demonstrates grade 2 thining and several grade 3 fissures." Also, "a 5mm x 3mm area of grade 3 fissuring over the anterior aspect of the lateral femoral condyle."

There was also thickenjng and scaring of my ALC, and signals on my medial and lateral meniscus' at different points. So, at only 19 years old, my knee is pretty much stuffed!

Thanks again,
Kathryn