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Author Topic: OCD (Osteochondritis Dissecans) Spreading?  (Read 5161 times)

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Offline rickduff

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OCD (Osteochondritis Dissecans) Spreading?
« on: November 02, 2007, 12:46:45 PM »
Was diagnosed with OCD of the left medial chondyle 22 years ago.  Had the leasion pinned, and 5 other surgeries since.  Two surgeries ago i had an oats procedure.  After 14 months had another surgery as the oats transplants as well as surrounding areas had died (dead bone.)  This latest surgery (12 months ago) was an Tru-Plug into the same area and slightly larger where the OATS was.  First 6 months were ok, but after that pain would come if I didn't have my weight completely on the tru-fit plugs.  Another MRI and now the leasion (area of dead bone) has expanded yet again out away from the tru-fit plugs.
The tru-fit plugs filled in an area about 22mm wide.

My question:  Can the death of bone be stopped?  At this point I should be going for a partial or full replacement, however I'm concerned about bone dying under this. 

I'm slightly worried that the dying bone spreads and I'm left with an above the knee amputation.

Thanks!

Offline MT

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Re: OCD (Osteochondritis Dissecans) Spreading?
« Reply #1 on: November 02, 2007, 02:22:19 PM »
Man I am so sorry to hear  about your complications.  Did you have an osteochondral allograft or autograft.  My doc said they had never heard of that happening with an allograft.  Have you had a second and third opinion.  Good luck.  My prayers are with you.  I am waiting on an allograft and they told me it was extremely rare to have the bone not fully bond to the allograft.  MT

Offline brattkids

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Re: OCD (Osteochondritis Dissecans) Spreading?
« Reply #2 on: November 04, 2007, 07:52:22 PM »
I had an allograft proceedure and the plug did not take. The plug itself died and had to be removed leaving me to have an autograft.
4/04 microfracture
5/04 debris removal
8/04 OATS with synthetic plugs
11/04 OATS traditional autograft medial femoral chondyle
05/05 debris removal and OATS assessment
6/05 Cadaver Allograft OATS lateral femoral chondyle
9/05 OATS redone could not save allograft plug
12/2006 2007 and 2008 scop

Offline rickduff

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Re: OCD (Osteochondritis Dissecans) Spreading?
« Reply #3 on: November 05, 2007, 06:17:18 PM »
I first had the traditional OATS autograft.  Those died... (as well as some bone around them.)
I then had 1 year ago tru-fit plugs put in... but it appears the area around the plugs is dying.. and the area of dead bone expanding.
brattkids: what is the current status of your leg?  no work on it in the last two years?  is it going ok?

Offline kathat

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Re: OCD (Osteochondritis Dissecans) Spreading?
« Reply #4 on: November 06, 2007, 11:51:01 PM »
Just thought I'd try to put your mind at ease somewhat. OCD is a problem where bone and cartilage separate. Once you get a knee replacement there is no cartilage/bone join left to cause a problem, so a TKR should be successful. It's not actually bone death that is the problem. The lesions they refer to are areas where cartilage has become separated from the bone underneath, rather than dead bone. Because cartilage protects the bone and provides a smooth surface for joint motion, once this has gone the joint becomes painful as things don't glide smoothly. The same happens in arthritis, but has a different cause. Hope this helps.
Kathy

Offline brattkids

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Re: OCD (Osteochondritis Dissecans) Spreading?
« Reply #5 on: November 07, 2007, 02:35:22 PM »
RickDuff,

So far I am doing good. I have done what the OS says and I am back up to strength and doing good at this point. I also had the tru-fit. I was one of the test cases before it was approved for general use and those didnt work for me either. Is your OCD from trauma or did it form spontaneously??


Kathat,

OCD can have bone death  Osteochondritis dissecans is a joint condition whereby a variable amount of bone and its adjacent cartilage loses its blood supply The bone undergoes avascular necrosis (death) and causes the cartilage to separate. While it is true that the lesions are refered to where the cartilage has separated it is usually due to bone death underneath that caused the disruption in blood supply. OCD can also be caused by a traumatic impact injury where the bone and cartilage are just broken off.
4/04 microfracture
5/04 debris removal
8/04 OATS with synthetic plugs
11/04 OATS traditional autograft medial femoral chondyle
05/05 debris removal and OATS assessment
6/05 Cadaver Allograft OATS lateral femoral chondyle
9/05 OATS redone could not save allograft plug
12/2006 2007 and 2008 scop

Offline kathat

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Re: OCD (Osteochondritis Dissecans) Spreading?
« Reply #6 on: November 07, 2007, 11:27:19 PM »
My apologies. My info does not refer to bone necrosis. It does however say that OCD is limited to the joint epiphysis, so should not be an issue in total joint replacement. I am hoping this is true - I have looked hard for info to the contrary, but found none.

Offline rickduff

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Re: OCD (Osteochondritis Dissecans) Spreading?
« Reply #7 on: November 08, 2007, 12:31:24 PM »
My OCD was caused by blunt force trauma.  It happened while doing some training in the Army.
I had my last MRI finally reviewed by my doctor and it appears the dead bone expansion isn't too bad.
They're now (finally) offering me a partial knee replacement.
Just have to get it scheduled.

Thanks all!

Offline brattkids

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Re: OCD (Osteochondritis Dissecans) Spreading?
« Reply #8 on: November 08, 2007, 01:06:07 PM »
Kathat,
 
I was told I would eventually need a TKR and that the OCD should not be an issue either. I sure hope not. I hope to be relatively pain free one day. Its not so bad right now so I am just taking one day at a time and when the pain gets to bad I will do the TKR- hopefully years and years and years from now LOL  ;D

RickDuff,

Best of luck to you on the partial!!! My injury was also caused by trauma so I hope to have good results when I need my TKR!!

Paulette



4/04 microfracture
5/04 debris removal
8/04 OATS with synthetic plugs
11/04 OATS traditional autograft medial femoral chondyle
05/05 debris removal and OATS assessment
6/05 Cadaver Allograft OATS lateral femoral chondyle
9/05 OATS redone could not save allograft plug
12/2006 2007 and 2008 scop