Traditionally, OCDs have been thought to occur as a result of repetitive trauma within the joint. However, more recent studies suggest the possibility of metabolic or genetic causes, which may alter the architecture or composition of the bone.
In OCDs of traumatic origin, such as in patients with a history of injury or recurrent trauma, both the cartilage and the bone are usually affected. These types of injuries may cause a shearing of the cartilage or a focal bone and cartilage injury with a saucer-shaped defect.
In those defects without a history of trauma, in which a new bone injury occurs, the bone scaffold is lost and a cystic lesion forms within the bone, which, as it progresses, may cause the overlying cartilage to collapse into the defect.
Intraoperative Picture of cartilage damage of the 1st metatarsal head during bunion surgery before and after removal of the bad cartilage and subchondral drilling (Below)
Osteochondral Autograft Transfer System (O.A.T.S.)
Intraop pic of cartliage damage inside big toe joint that was cleaned up and then drilled to stimualte cartilage regrowth (below)
Intraop Pic before and after subchondral drilling for OCD 1st met head
1st Met Head after Oats procedure for OCD
Intraop pics of Cartilage damage of 1st met head before adn after curretage and subchondral drilling
Intraop pic of OCD of the first metatarsal before and after curretage and subchondral drilling
OCD of the 1st metatarsal before and after subchondral drilling