Osteochondral defects (OCDs)

What is an osteochondral defect?

Osteochondral defects are local areas of joint damage. They are different to arthritis as they are areas of cartilage softening rather than hardening. Imagine your bone is a chocolate malteaser! The chocolate surrounding the biscuit is the articular cartilage. If I small area of chocolate were to be removed the space left is called an osteochondral defect. The defect in sever cases can expose the bone beneath.

How does it present?

These injuries most often occur following single or multiple traumas to the involved joint. It is not the damage to the cartilage itself that causes the pain but the change in load and pressure on the bone beneath (subchondral bone). Pain occurs when loading the joint and it can become swollen and stiff.

How is it treated?

It is important to pick OCDs  up to avoid further joint damage. Common treatment involves a period of immobilization and graduated mobility and strength programme but in some cases surgical intervention in the form of excision and microfracturing can be necessary to preserve the joint in the long term.

What You Need To Know
  • Common following trauma to the joint.
  • Ankle swelling and stiffness can be seen.
  • Pain worsens with prolonged weight bearing.
  • OCDs are commonly missed.