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What happens to people with osteochondritis dissecans? I had this problem when I was a teenager. Now that I'm in my 30s, I'm old enough to take better care of myself. So I'm wondering if it will come back.

Osteochondritis dissecans (OCD) is a bone defect in a joint (usually the knee). A fragment of cartilage or cartilage with a piece of bone attached to it comes loose and can become a free-floating body inside the joint. The cause of OCD varies from patient to patient. The most common causes are repetitive microtrauma (most common in athletes), inflammation, loss of blood supply, and abnormalities in bone formation. Treatment depends on the severity of the condition. And the degree of severity depends on how large the fragment is and whether or not it has detached causing a hole in the bone where it came from. A mild (grade I) case of OCD means there's a lesion but the frayed piece of cartilage is stable. In other words, it is still attached to the bone. During arthroscopic exam, the surgeon cannot move the fragment away from the bone. With a stage II lesion, the cartilage is starting to show some signs of separation between the cartilage and the bone. Stage III lesions are partially detached. An MRI can be used to see just how attached (or detached) the fragment is. And with a stage IV lesion (the subject of this study), the fragment has come loose, leaving a crater or hole in the bone. This hole is referred to as a grade IV defect. The loose fragment of cartilage usually has a piece of the underlying bone still attached. You didn't mention any pain or problems at this time. Usually osteochondritis dissecans affects teens and young adults involved in sports activities. So you're not likely to develop this same problem now that you are in your 30s. But you may experience some increased pain, stiffness, and loss of motion if osteoarthritis develops. Your results are somewhat dependent on the severity of the lesion and the treatment provided at the time of diagnosis. Studies show that the long-term prognosis is best for younger patients with mild lesions. They are treated nonoperatively with modified activities and by keeping weight off the affected knee. But even with surgery to repair the defect, the long-term results can be very favorable. Patients report being able to do everyday activities without any pain or difficulty. Participating in competitive sports may not be as easy due to pain and stiffness.

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