Diagnosis Explanation:

Osteochondritis dissecans (OCD) is a condition where a small piece of bone and cartilage in the knee joint loses blood supply and begins to separate from the surrounding bone. This commonly affects adolescents and young adults and is often due to repetitive stress, trauma, or genetic factors. Symptoms include knee pain, swelling, stiffness, clicking, locking, and occasional instability. Severe cases may require surgical treatment if the bone fragment becomes loose.

Specific Work Modifications:

• If your job requires standing or walking: Take frequent seated breaks and use shock-absorbing footwear.
• If your job involves lifting: Avoid deep squatting and twisting motions to prevent stress on the knee joint.
• If your job is desk-based: Keep your leg elevated when sitting and stretch periodically.
• Avoid: Prolonged standing, kneeling, excessive stair climbing, and repetitive impact on the knee.

Specific Activity Modifications:

• If you run or play sports: Reduce high-impact activities and transition to low-impact options like swimming or cycling.
• If you hike: Stick to flat trails and use trekking poles for additional support.
• If you do weightlifting: Avoid deep squats, lunges, and leg presses until fully healed. Focus on controlled, low-impact strength training.
• Avoid: Jumping, pivoting, sprinting, and high-impact exercises that place stress on the knee.

Recommended Supplements:

• Collagen Peptides – 10g daily to support cartilage and bone repair.
• Glucosamine & Chondroitin – 1500mg/1200mg daily for joint health.
• Vitamin D3 + Calcium – 1000 IU/500mg daily to support bone regeneration.
• Omega-3 Fatty Acids – 1000mg daily to reduce inflammation.
• Vitamin C – 500mg daily to promote collagen synthesis.

Recommended Nutrition and Hydration:

• Increase Lean Protein (chicken, fish, eggs, tofu) to aid bone and cartilage healing.
• Eat Anti-Inflammatory Foods (berries, leafy greens, turmeric, nuts) to reduce swelling.
• Consume Hydrating Foods (cucumber, watermelon, citrus) to maintain joint lubrication.
• Limit Processed Foods & Sugars to prevent inflammation.
• Hydration: Drink 8-10 cups of water daily to maintain joint function and support healing.

Home Exercise Prescription:

Early Phase (Reducing Pain & Swelling, Improving Mobility):

• RICE Protocol – Rest, Ice (15-20 min, 3x/day), Compression (brace if prescribed), Elevation.
• Quadriceps Sets – Tighten thigh muscle, hold for 5 seconds, repeat 10 reps, 3x/day.
• Heel Slides – Gently slide heel toward buttocks to maintain knee mobility, 10 reps, 2x/day.
• Seated Knee Extensions – Slowly extend knee, hold for 5 seconds, repeat 10 reps, 2x/day.

Strengthening Phase (Regaining Strength & Stability):

• Straight Leg Raises – Keep knee straight, lift leg, hold 5 seconds, repeat 10 reps, 2x/day.
• Glute Bridges – Lie on back, lift hips while keeping hamstrings relaxed, 10 reps, 2x/day.
• Mini Squats (No Deep Bending) – Slight knee bends while keeping weight on heels, 10 reps, 2x/day.

Advanced Phase (Building Strength & Returning to Activity):

• Step-Ups – Step onto a low platform, push through the heel, repeat 10 reps, 2x/day.
• Stationary Cycling – Low resistance for 10-15 minutes/day.
• Balance Exercises – Stand on injured leg for 10-20 seconds, increase as tolerated.

Helpful Books:

1. The Knee Injury Bible: Everything You Need to Know About Knee Pain, Prevention, and Treatment – Kevin R. Stone, MD.
2. Heal Your Knees: How to Prevent Knee Surgery and What to Do If You Need It – Robert Klapper, MD, and Lynda Huey.

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.