Osteochondritis Dissecans
To Karey Haisten-Matlock and her husband, William Matlock III, the way their 13-year-old son, Ryland, works through the pain of osteochondritis dissecans (OCD) is truly strength personified. OCD is a condition in which bone underneath the cartilage of a joint dies and begins to chip off due to lack of blood flow. The cause of OCD is unknown, although some researchers believe there could be a genetic component. The Signal Mountain, Tennessee, youngster began showing symptoms of the illness at age 5. “While other children would get up easily from the dinner table or their desks at school, Ryland would struggle to stand up and start walking,” his mother said. At that time, however, Ryland also was being treated for a lung condition he has suffered from since birth—and his knee problems were put on the back burner for a few years. “Ryland loves sports,” Karey said. “But by age 11, he would have to be carried off the basketball court by his dad after most people had left because he did not want anyone to see his pain or that he was having trouble walking.” After months of physical therapy, one of Ryland’s doctors ordered MRIs of his knees. The MRIs showed bilateral OCD lesions and the Matlocks finally had a diagnosis. But they also wanted a second opinion from Mininder S. Kocher, M.D., M.P.H., of Children’s Hospital Boston. Dr. Kocher is an internationally recognized orthopedic surgeon with special interests in OCD and other pediatric sports medicine conditions. “That’s how we came to be at Children’s of Alabama,” Karey said. “Ryland’s surgeon, Dr. Reed Estes, had worked with Dr. Kocher in Boston, and we were so happy to find someone with his expertise located much closer to our home.” Dr. Estes said UAB Sports Medicine at Children’s is pleased to be able to offer this service to Ryland and other children who have OCD. “Most orthopedists do not see OCD lesions frequently during their career,” he said. “But because we have a specialized interest in pediatric and adolescent sports medicine, we see and manage them frequently.” Because of OCD, Ryland has had more than 10 MRIs and, combined with his lung condition, over a dozen surgeries—four of them within the last year. “You would never know anything was wrong with him by just looking at him,” his mother said. “He was one of the high scorers on his lacrosse team last spring in between his elbow and knee surgeries. Then he secured a spot on his school’s competitive basketball team less than 16 weeks out from another surgery, during which he had three pins put his knee and a piece of bone removed.” His mother also tells of the time he chipped a bone in his knee while at a sleepover birthday party at a friend’s house. “He waited until the next day before telling anyone. His knee was huge and swollen and he was in so much pain, but he stayed with his friends and participated in the birthday party until the next afternoon when I picked him up. He is so strong, and he never complains.” Ryland’s prognosis is uncertain. His parents hope that as he grows and his bones mature, he will get better. “My dream is that he will just be a normal healthy child who can live without pain or fear that his bones may chip off while he is playing,” Karey said. “I want him to grow up to be a healthy, happy adult who does not live in pain.” In the meantime, he will continue to visit Dr. Estes and the team at Sports Medicine every few months. He also sees Peter Weiser, M.D., in Rheumatology, and Maria Descartes, M.D., in Genetics. The Matlocks said they have never regretted choosing Children’s. “Our doctors are very knowledgeable, and all the staff we have encountered are loving and helpful and reassuring,” Karey said. “Megan Steirer, one of the Sports Medicine athletic trainers, has definitely made our experience so much more positive. She is always so helpful, honest, empathetic and upbeat. She returns emails and messages even if she is not at the office, and follows through with what she says she will do.” Ryland has one brother, 10-year-old Wilson. Unfortunately, on his ninth birthday last year, Wilson also was diagnosed with OCD. The Matlocks were, of course, devastated by the diagnosis, but will continue to look to Children’s—now for the care of both of their sons. “Just knowing you have a team on your side that you can trust when your children are going through so much is a great feeling,” Karey said. Ryland agrees. “Dr. Estes is awesome,” he said. “He fixed me to be able to play sports again!”
