Knee Cartilage Injuries

OCD lesions can occur due to a single traumatic event like a forceful twist or pivot, or a direct blow to the knee. However, it can also arise from repetitive strain on the knee joint over time, often seen in athletes participating in high-impact sports like soccer, basketball, or gymnastics. In some cases, disruptions in blood flow to the bone may also contribute to the development of OCD lesions. Some individuals may be genetically predisposed to developing these conditions as well.

OCD lesions are often categorized based on their severity:

• Grade I: The cartilage has softening but remains intact.
• Grade II: The cartilage surface is fragmented but remains in place.
• Grade III: The fragment is partially detached, and there may be a cyst in the bone underneath.
• Grade IV: The fragment is completely detached and may be loose in the joint.

Initial symptoms of an OCD lesion may include:

• Pain and swelling in the knee, especially after activity or exercise.
• A feeling of the knee giving way or locking during movement.
• A sensation of something moving around inside the knee joint (if the fragment is loose).
• Decreased range of motion.

Over time, if left untreated, an OCD lesion can lead to persistent pain, instability, and potentially early-onset arthritis in the knee.

While some mild (Grade I or II) lesions may heal with rest and non-surgical treatment, particularly in children or adolescents, more severe lesions usually require surgical intervention. The likelihood of a lesion healing on its own decreases with age and the lesion’s size.

Diagnosis of an OCD lesion typically begins with a physical examination, assessing pain, swelling, and range of motion in the knee. Imaging tests such as X-rays or MRI scans are then used to confirm the diagnosis and evaluate the lesion’s size and severity.

Treatment depends on the lesion’s severity and the patient’s age. For children and adolescents whose bones are still growing, conservative treatment, including rest, activity modification, and physical therapy, may allow the lesion to heal. However, if conservative treatment fails or the lesion is severe or unstable, surgery may be necessary. Surgical procedures may include drilling to stimulate healing, grafting to replace the damaged cartilage and bone, or securing the loose fragment back into place.