Osteochondrosis Dissecans (OCD) is a cartilage disease of the joints where there is not trauma, not infection and not instability, but there is a defect that forms in the cartilage. This cartilage defect can be severe enough to cause severe pain and lameness and result in permanent arthritis. Normal cartilage is the rubber-like, resilient, smooth covering of the ends of bones. It is attached to bone underneath the weight bearing surface and to the synovial membrane along the sides of the articulating surface. The synovial membrane produces synovial fluid and has blood supply that feeds the cartilage through diffusion. Cartilage does not contain blood vessels or nerves and is made of cells called chondrocytes. Chondrocytes make collagen. Cartilage has limited repair capabilities; therefore, cartilage is difficult to heal, and damaged cartilage is usually replaced by scar tissue called fibrocartilage.

This radiography is of an 18 month old Chesapeake Bay Retriever with an 8 month history of lameness, where the cartilage flap has already formed.
Osteochondrosis
OCD occurs when cracks form in the articular cartilage affecting the underlying (subchondral) bone. OCD is caused by blood deprivation in the subchondral bone. This loss of blood flow causes the subchondral bone to die and to be absorbed, leaving the overlying cartilage unsupported and unfed. As a result, even normal movement causes the cartilage to fracture and release, forming a flap of cartilage tissue that will eventually break away and float within the joint fluid. This “joint mouse” will cause further damage to unaffected cartilage.

OCD commonly affects the shoulder joint, but can also affect the elbow, the knee and the hock joints.

Breed Specific

OCD is common in the Bernese Mountain Dog, Bull Terrier, German Shepherd, Giant breed dogs, Golden Retriever, Great Dane, Labrador Retriever, Large breed dogs, Rottweiler and the Saint Bernard. It affects male dogs more than females and is a disease that is noted in young dogs less than one year of age.

Common Treatment Protocol

Diagnosis is made most commonly with radiographs but, in some challenging cases, MRI or Arthroscopy may be necessary.

Exercise restriction for 2-3 weeks, nonsteroidal anti-inflammatory drugs (NSAIDs); chondroprotectants and nutraceuticals. Conservative therapy is generally unrewarding once flap formation has occurred.

Early surgery, before arthritis has occurred, is the most commonly recommended therapy. The surgery removes the cartilage flap and the defect is curetted (burred) down to bleeding bone. This allows the defect to fill with the scar tissue, called fibrocartilage, within 4 to 8 weeks. In these cases, degenerative joint disease will still progress, and the pet will be intermittently painful. At some institutions, cartilage grafts taken from non-weight bearing areas of the joint and transplanted into the cartilage defect have promising results.

Stem Cell Treatment

Cartilage does not have a blood supply and is therefore slow to heal. Most cartilage defects will not heal on their own and will need to be removed surgically or arthroscopically. Once the defect is removed, however, stem cells can promote normal regrowth of cartilage, instead of the fibrocartilage that will form in the absence of stem cells. In some cases, arthroscopic drilling into the underlying bone and the application of stem cells has resulted in complete regeneration of the defect.

At Safari, as soon as OCD is diagnosed, we recommend stem cell therapy into the affected joints. Reevaluation at 30 days should show some clinical resolution, if not, then a surgical or arthroscopic procedure is planned with the addition of stem cells into the defect.

Panzer's Journey to Wellness

Panzer suffered from Osteochondrosis of the elbows (aka fragmented coronoids), that is, until he received stem cell injections and after care rehabilitation at Safari.

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