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PHYS THER
Vol. 85, No. 7, July 2005, pp. 665-675
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Case Reports

Physical Therapist Management of an Adult With Osteochondritis Dissecans of the Knee

Michael P Johnson

MP Johnson, PT, MS, OCS, is Director of Professional Development, Mercy Rehab Associates, 1503 Lansdowne Ave, Darby, PA 19023 (USA) (mjohnson1{at}mercyhealth.org)

Background and Purpose. Osteochondritis dissecans (OCD) primarily occurs between 10 and 20 years of age. Adult patients (>20 years) tend to respond poorly to nonsurgical management. This case report describes the physical therapist management of an adult with OCD at the tibiofemoral joint. Case Description. A 24-year-old woman had insidious onset of right knee pain. Magnetic resonance imaging confirmed the diagnosis of OCD. Interventions included iontophoresis, strengthening exercises, and instruction in strategies to minimize loading across the knee. Outcome. The patient received 5 intervention sessions. At discharge and 9-month follow-up, she reported 95% function (Single Assessment Numeric Evaluation) and no pain while performing full work duties. Discussion. This case illustrates the process, including the use of evidence, of making clinical decisions about the physical therapist management of an adult with OCD.

Key Words: Cartilage diseases • Clinical decision making • Connective tissue • Iontophoresis • Knee injuries


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