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Osteochondritis Dissecans of the Knee Physical Therapy


Osteochondritis dissecans (OCD) is a condition that affects the joints, particularly the knee. It occurs when a fragment of cartilage and bone separates from the underlying bone, causing pain, swelling, and limited range of motion. Physical therapy plays a crucial role in managing OCD of the knee, offering a non-invasive approach to pain relief, improved function, and complete recovery.

Physical Therapy Treatment for Osteochondritis Dissecans of the Knee

Physiotherapy is an essential component of the treatment plan for OCD of the knee. It aims to address the pain, improve joint mobility, strengthen the muscles around the knee, and restore normal function. The specific treatment approach will vary depending on the severity of the OCD lesion, the patient’s age, and their overall health.

Pain Management

The initial focus of physical therapy is to manage pain and inflammation associated with OCD. This may involve:

  • Rest: Avoiding activities that aggravate the knee joint is crucial to allow healing and reduce pain.
  • Ice application: Applying ice packs to the affected area can help reduce inflammation and pain.
  • Compression: Wearing a compression bandage or brace provides support and stability to the knee joint.
  • Elevation: Elevating the leg above the heart level can help reduce swelling and pain.
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter or prescription NSAIDs can help alleviate pain and inflammation.

Range of Motion Exercises

Once the pain is under control, physical therapy focuses on improving the range of motion in the knee joint. Gentle range-of-motion exercises help to prevent stiffness and promote joint mobility. These exercises may include:

  • Passive range of motion: A physical therapist gently moves the knee joint through its full range of motion.
  • Active range of motion: The patient actively moves the knee joint through its full range of motion.
  • Stretching exercises: Stretches for the hamstrings, quadriceps, and calf muscles can improve flexibility and range of motion.

Strengthening Exercises

Strengthening the muscles around the knee joint is crucial for stabilizing the joint and reducing the risk of re-injury. These exercises may include:

  • Quadriceps sets: Tightening the thigh muscles for a few seconds and then relaxing them.
  • Hamstring curls: Lying on the back and pulling the heels towards the buttocks.
  • Straight-leg raises: Lifting the leg straight up while lying on the back.
  • Closed-chain exercises: Exercises like squats, lunges, and step-ups that involve moving the entire body.

Proprioception Training

Proprioception is the body’s awareness of its position and movement in space. These exercises help to improve the knee joint’s stability and reduce the risk of future dislocations. These exercises may include:

  • Balance exercises: Standing on one leg, balancing on a wobble board, or walking heel-to-toe.
  • Neuromuscular electrical stimulation (NMES): Using electrical currents to stimulate muscle contractions.

Functional Rehabilitation

The final stage of physical therapy focuses on restoring normal function and enabling the patient to return to their daily activities. Functional rehabilitation exercises may include:

  • Stair climbing: Gradually increasing the number of stairs climbed.
  • Running: Starting with slow jogging and gradually increasing the distance and intensity.
  • Sports-specific drills: Incorporating exercises that simulate the movements involved in specific sports.

Rehabilitation Timeline

The rehabilitation timeline for OCD of the knee varies depending on the severity of the lesion and the patient’s response to treatment. In general, mild cases may resolve within a few months with physical therapy alone, while more severe cases may require surgery followed by physical therapy.


What are the symptoms of osteochondritis dissecans of the knee?

The main symptoms of OCD of the knee include:

  • Knee pain: Pain behind or around the kneecap, especially during activity or weight-bearing.
  • Swelling: Swelling in the knee area.
  • Catching or locking sensations: Feeling like the knee is catching or locking when moving.
  • Limited range of motion: Difficulty bending or straightening the knee fully.

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