Osteochondritis Dissecans
What is Osteochondritis Dissecans?
Osteochondritis Dissecans (OCD) is an abnormality in development of
bone from cartilage. As a result, within joints such as the shoulder,
elbow, knee, and hock (ankle), a flap of cartilage can develop causing
lameness. The shoulder and elbow are more commonly affected. The
development of OCD is secondary to multiple factors including diet,
growth rate, genetics, trauma, hormonal imbalance and joint
architecture.
Who develops OCD?
OCD frequently occurs more in large and giant breeds. Notably,
breeds affected most commonly include Labrador Retrievers, Golden
Retrievers, and Newfoundlands. Other breeds that can be affected
include Bernese Mountain Dogs, Chow Chows, German Shepherds, Mastiffs,
Old English Sheepdogs, Rottweilers, and Standard Poodles.
In cases such as OCD of the shoulder, male dogs care more commonly affected than female dogs.
How is OCD diagnosed?
Most dogs will start showing clinical signs as young as 4-7 months of
age. Most are recognized to have a lameness that becomes worse with
heavy exercise and after prolonged rest. In some cases, no obvious
affected leg can be determined as OCD is in both limbs.
Radiographs are often diagnostic but in more difficult cases other
tests, including arthrography (x-rays with contrast within the joint),
CT scan or MRI may be used.
What is the treatment and prognosis?
Surgery or arthroscopy will often be the treatment of choice.
Factors that may affect this decision include the joint affected, the
degree of secondary arthritis, or if a flap of cartilage is not
present. The goal of surgery is to retrieve the flap of unhealthy
cartilage and prepare the area where the flap developed to allow a
scar-type cartilage (fibrocartilage) to develop.
Shoulder: Surgery or arthroscopy is the treatment of choice.
75% of patients will show no signs of lameness after surgery, 23% show
mild lameness and 2% show persistent lameness.
Stifle (Knee): Surgery is indicated if a large fragment is recognized. Chances for complete resolution of lameness are small.
Tarsus (Ankle): Most dogs will show mild improvement in
lameness immediately following surgery, but will continue to show some
gait abnormalities once they have returned back to normal activity
levels.
What is the aftercare?
Following surgery, patients should be restricted to leash
confinement for a minimum of 4 weeks. Following that time period, a
gradual increase in activity will occur over another 4 weeks. Pain
management with non-steroidal anti-inflammatory drugs will usually
continue for the first 4-7 days after surgery. Long term management,
whether surgery was performed or not, includes weight restriction,
controlled exercise and pain management as needed.
Do you have any recommendations?
As genetics play an important role in the development of OCD, any
patient diagnosed with this condition should not be bred. In addition,
parents, siblings or previous offspring of an affected patient should
not be bred.