"Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. Osteochondritis dissecans is a bone and cartilage condition that most often occurs in the knee. Osteochondritis dissecans (OCD) is the end result of the aseptic separation of an osteochondral fragment with the gradual fragmentation of the articular surface and results in an osteochondral defect. 393. Your childs doctor will select a surgical technique based on the type of osteochondritis dissecans, your childs age, and other factors. Take steps to recover from knee surgery quickly and safely! Koehler SM, Walsh A, Lovy AJ, Pruzansky JS, Shukla DR, Hausman MR. J Shoulder Elbow Surg. If the lesion has broken away, nonsurgical treatment is not indicated. Osteochondritis dissecans (OCD) is a common joint disorder in knee, ankle and elbow, however it can be rarely found in glenohumeral joint. Their physician may recommend rest, ice, compression, and elevation (RICE), combined with non-steroidal anti-inflammatory medications for pain. What causes elbow osteochondritis dissecans? Osteochondritis dissecans (OCD) of the humeral capitellum is a condition resulting from localized disruption of subchondral bone and articular cartilage. TLDR. Kessler JI, Jacobs JC Jr, Cannamela PC, Weiss JM, Shea KG. Young athletes involved in high-impact sports can sustain an osteochondritis dissecans injury from motions that put repetitive stress on the joint. Capitellar osteochondritis dissecans (OCD) can be a significant problem in adolescent overhead athletes. Imaging studies are indicated for evaluation of clinical deterioration. Learn more about Sports Ultrasound Clinic. In fact, subtle restriction in range of motion may be the most important clinical sign. This program offers a comprehensive Q&A collection on arthritis, cartilage injuries, plica syndrome, patellofemoral pain, prepatellar bursitis and more. Overlying articular cartilage may be intact in an unstable fragment.6 Distinguishing between stages II and III is important in planning for surgery.13 If the MRI demonstrates an unstable lesion (stage III or IV), arthroscopy should be employed to determine the integrity of the cartilaginous surface. I am a 55 year old runner, with 40 plus marathons. Surgical procedures to repair osteochondritis dissecans of the knee or elbow include: OATS, or osteochondral autologous transplantation surgery, is a treatment option for certain OCD injuries. Recently, it has been reported with increasing frequency among young female athletes.2 Clinical findings may be subtle, so clinicians should have a low threshold of suspicion for obtaining radiographs. 2021 Apr 20;5(4):745-753. doi: 10.1016/j.jseint.2021.03.004. 2021 Jan 6;9(1):2325967120970205. doi: 10.1177/2325967120970205. Accessed Aug. 7, 2018. Knee Surg Sports Traumatol Arthrosc. Plain films will detect a circumscribed area of necrosis but are a poor method of assessing articular cartilage and cannot be used to determine stability.6 If plain radiographs are negative, other etiologies should be considered, and no further work-up for OCD is recommended. This article also presents the authors' recommended surgical technique. Osteochondritis dissecans (OCD): Clinical manifestations and diagnosis. Historically, immobilization has been encouraged; however, prolonged splinting leads to quadriceps atrophy and stiffness, which may complicate the condition.5 Persistent symptoms in a compliant, conservatively treated patient or the onset of joint catching or grinding suggest detachment, with the development of a loose body, and are an indication for arthroscopic evaluation.1. This content does not have an Arabic version. Approximately 21 percent of patients relate onset of symptoms to injury.5 Most have pain related to activity5 and stiffness after periods of disuse. Should you play sports with an OCD lesion in your knee? Arthroscopic surgery in athletes with osteochondritis dissecans of the elbow. Arthroscopic surgery in athletes with osteochondritis dissecans of the elbow Authors Frank de Graaff 1 , Matthijs R Krijnen , Rudolf W Poolman , W Jaap Willems Affiliation 1 Department of Orthopaedics and Traumatology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands. In case of progression of the lesion or failure of conservative treatment a reparative, restorative or palliative surgical intervention can be done. In young athletes who are not finished growing, there is often a good chance that the lesion will heal on its own. One study noted that boys are three to four times as likely to be affected as girls.3 The incidence appears to be increasing in women2 and in younger children,1 perhaps because of increasing involvement in organized sports. Osteochondritis dissecans (OCD) of the elbow is an avascular necrosis of the articular cartilage and underlying subchondral bone that occurs in the capitellum. The .gov means its official. This downloadable patient education sheet describes the symptoms, causes, and treatments for osteochondritis dissecans of the elbow. }, author={Paul G Talusan and Matthew David Milewski and Jason O. author = "Chau, {Michael M.} and Tompkins, {Marc A.}". Bookshelf The incidence of OCD in the general population is estimated to be 15 to 30 cases per 100,000 persons.1,5 Although rare, it is recognized as an important cause of joint pain in active adolescents. The purpose of this review is to evaluate the results of arthroscopic surgery, including debridement, fragment fixation, microfracturing, and osteochondral autografting, in athletes with . The most commonly affected areas include, in decreasing order of frequency, the femoral condyles, talar dome and capitellum of the humerus.6 The knee is involved about 75 percent of the time.3 Classically, the nonweight-bearing medial femoral condyle is the location in 85 percent of cases of OCD of the knee.7 OCD must be ruled out in the contralateral joint, because 20 to 30 percent of cases are bilateral.3 Multiple lesions, while rare, have occasionally been noted.8 Less frequent locations include the patella, femoral head, glenoid of the scapula, tibial plateau, head of the talus and vertebrae.8,9 Capitellar lesions of the humerus are common in adolescent baseball pitchers and gymnasts.9,10. Arthroscopy2011;27(7):986-993. Osteochondritis Dissecans Knee Update, 4 Years Later February 9, 2016 - lynne Once upon a time, 4 years ago, I had knee surgery on each of my knees. Accessed Aug. 8, 2018. Please note that as an Amazon Associate I earn from qualifying purchases. Copyright 2011 Arthroscopy Association of North America. Surgery might be necessary if the fragment comes loose and gets caught between the moving parts of your joint or if you have persistent pain. This course teaches you what to expect and how to prepare for surgery to have the best outcome. 2021 Oct;12(4):407-417. doi: 10.1177/1947603519847735. Return to sports can be variable depending on the type of osteochondritis dissecans lesion and the treatment. and transmitted securely. JaapWillemsM.D., Ph.D. Add to Mendeley https://doi.org/10.1016/j.arthro.2011.01.002 Get rights and content Purpose Before Careers. Osteochondritis dissecans can increase your risk of eventually developing osteoarthritis in that joint. It most often occurs in the knee, but it can develop in the elbow. The Pediatric Sports Medicine Division provides comprehensive care to athletes of all ages and abilities, from professional athletes to eager novices. American Academy of Orthopaedic Surgeons. A prospective clinical study used joint scintigraphy to investigate conservative treatment of juvenile osteo chondritis dissecans (JOCD) of the femoral condyle and found that based on specific indications for failure of conserva tive treatment, 50% of these patients failed and under went surgery. She had discomfort with weight bearing and 5-degree limitation to full extension. FOIA If this happens, the joint can get stuck, until its moved manually or otherwise manipulated. This bone and cartilage can then break loose, causing pain and possibly hindering joint motion. J Am Acad Orthop Surg. Limited range of motion may be the only notable clinical sign. Through the stories of a dozen athletes whose injuries and recovery advanced the field (including Joan Benoit, Michael Jordan, Brandi Chastain, and Tommy John), Dr. Geier explains how sports medicine makes sports safer for the pros, amateurs, student-athletes, and weekend warriors alike. government site. abstract = "Osteochondritis dissecans of the knee is a relatively rare disorder in young athletes that can lead to premature osteoarthritis. Nonoperative treatment is typically attempted for patients with open physes, stable lesions, and minimal symptoms. Hergenroeder AC, et al. Federal government websites often end in .gov or .mil. Before The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Learn more about Sports Medicine Division. Osteochondritis dissecans occurs most often in children and adolescents. Osteochondritis dissecans of the knee is being seen with increased frequency in pediatric and young adult athletes and is thought to be, in part, owing to earlier and increasingly competitive sports participation. Dr. David Geier is an orthopedic surgeon and sports medicine specialist in Charleston, South Carolina and Charlotte, North Carolina. Orthop J Sports Med. Learning the proper mechanics and techniques of their sport, using the proper protective gear, and participating in strength training and stability training exercises can help reduce the chance of injury. This may include specialized manipulations of the joint, such as a Wilson test of the knee, to see if a particular rotation of the knee causes pain. This article discusses the anatomy, pathoanatomy, history, physical examination, imaging, management algorithm, and outcomes of surgical treatment of osteochondral lesions in these patients. I quit playing soccer because I couldn't deal with the pain. Arthroscopy may be performed to remove any loose bone or cartilage in the joint and to clean up the frayed edges at the site of the OCD. 2010 Sep;18(9):557-67. doi: 10.5435/00124635-201009000-00007. 1987 Mar-Apr;125(2):194-200. doi: 10.1055/s-2008-1044914. Nonoperative treatment is typically attempted for patients with open physes, stable lesions, and minimal symptoms. X-rays showed an area of lucency around an oval bony fragment measuring about Early on the cartilage over this diseased bone is intact, but it can later break off with the underlying bone and float freely within the knee joint. The cause of osteochondritis . For young children whose bones are still developing, the injury might heal by itself. Epub 2018 Jan 18. Cartilage. Song Q, Zeng X, Huang H, Long L, Xu J, Cui S, Li Z, Ma X. J Orthop Surg Res. She was pain-free with full range of motion and a stable knee. If OCD of the knee is suspected, anteroposterior, lateral and tunnel-view (knee in flexion) radiographs are indicated. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Book: Mayo Clinic Family Health Book, 5th Edition, Newsletter: Mayo Clinic Health Letter Digital Edition, Science Saturday: Pioneering living donor cartilage transplants. The medical team may not be aware of the multiple ways that a rare disease can change the quality of life of the patient and family. Symptoms include pain, swelling and stiffness. The site is secure. Arthroscopic surgery in athletes with osteochondritis dissecans of the elbow. We also conduct safe-training programs and clinics for coaches. Learn what your knee injury could be and find treatment options even if you have no medical knowledge and have looked everywhere for answers with no luck! Weight loss surgery reduces the risk of premature death, 392. .css-17zuyas{display:block;font-family:Sailec,Sailec-fallback,Helvetica,Arial,sans-serif;font-weight:bold;margin-bottom:0;margin-top:0;-webkit-text-decoration:none;text-decoration:none;}@media (any-hover: hover){.css-17zuyas:hover{color:link-hover;}}@media(max-width: 48rem){.css-17zuyas{font-size:1rem;line-height:1.4;}}@media(min-width: 40.625rem){.css-17zuyas{font-size:1rem;line-height:1.4;}}@media(min-width: 48rem){.css-17zuyas{font-size:1rem;line-height:1.4;}}@media(min-width: 64rem){.css-17zuyas{font-size:1.2rem;line-height:1.4;}}.css-17zuyas h2 span:hover{color:#CDCDCD;}Your Guide to Ultrarunning, What You Need to Know About Threshold Training, Periodized Training Can Help You Hit Your Goals, What Every Runner Should Know about Fascia, Why Slowing Down Can Help You Get Faster (Really! ), Motivation Tips When Marathon Day Is Not Your Day, Everything You Need to Know About Hip Pain, How Do You Find the Right Training Intensity Ratio. My mum had taken me to A&E a few times by this point after I would fall down the stairs or just fall over randomly (this was my knee giving in). Depending on the joint that's affected, signs and symptoms of osteochondritis dissecans might include: If you have persistent pain or soreness in your knee, elbow or another joint, see your doctor. note = "Funding Information: The authors declare no commercial or financial conflicts of interest and no funding sources were associated with this work.". More aggressive intervention is indicated in older symptomatic patients.3, Nonsurgical management includes observation. Copyright 2011 Arthroscopy Association of North America. In these cases, arthroscopy is imperative to evaluate the stability of the lesion and visualize the overlying cartilage. Osteochondritis Dissecans of Smaller Joints: The Elbow. Epub 2017 Apr 8. The included studies had low methodologic quality and showed satisfactory results regarding pain, return to sports, and elbow function. Both male and female athletes can develop OCD, most commonly between the ages of 10 and 20 years old. Epub 2019 Jun 24. Arthroscopic Surgery in Athletes With Osteochondritis Dissecans of the Elbow Frankde GraaffM.D. Click here to go to Dr. David Geiers Amazon Influencer store! Competitive sports should be avoided for six to eight weeks. Please enable it to take advantage of the complete set of features! Common knee injuries a young athlete can suffer. These may include drilling small holes at the site to cause bleeding and hopefully the formation of scar tissue (fibrocartilage). Harbrecht A, Hackl M, Leschinger T, Wegmann K, Seybold D, Mller LP. Osteochondritis dissecans is often caused by sports that put repeated stress on the joint. The doctor will check for pain along the affected joint line and may order an x-ray or MRI to help them see the joint. Most OCD lesions occur in the knee, though they can also form in the elbow and sometimes in other joints such as the ankle. 2017. OCD is a relatively rare disorder,. Clinically, the patient remained unable to fully extend her right leg. 2011. JSES Int. N1 - Funding Information: PURPOSE: Osteochondritis dissecans (OCD) of the elbow is an avascular necrosis of the articular cartilage and underlying subchondral bone that occurs in the capitellum. 2021 Mar 8;5(3):564-570. doi: 10.1016/j.jseint.2020.12.017. OCD has typically been known to affect males between 10 and 20 years of age. Osteochondritis dissecans of the talus is a subset of osteochondral lesions of the talus that also includes osteochondral fractures, avascular necrosis, and degenerative arthritis. 2019. THE CONTENT DOES NOT AND IS NOT INTENDED TO CONVEY MEDICAL ADVICE AND DOES NOT CONSTITUTE THE PRACTICE OF MEDICINE. Bethesda, MD 20894, Web Policies Due to a large number of questions I have received over the years asking about products for health, injuries, performance, and other areas of sports, exercise, work and life, I have created an Amazon Influencer page. Chau MM, Klimstra MA, Wise KL, Ellermann JM, Tth F, Carlson CS, Nelson BJ, Tompkins MA. Meet Grady He was playing hockey at the highest level a 12-year-old player in Canada could play when osteochondritis dissecans in both knees forced him to take time off. Your Privacy Choices: Opt Out of Sale/Targeted Ads. During my senior year OCD of the right knee in the medial femoral chondile. Members of our orthopedics and sports medicine teamtravel to local and regional schools, youth groups and sports clubs to teach leg strengthening and other techniques with a goal of dramatically reducing overuse injuries like osteochondritis dissecans. , Ph.D. Add to Mendeley https: //doi.org/10.1016/j.arthro.2011.01.002 Get rights and content Purpose Before Careers may be the important. ):194-200. doi: 10.1016/j.jseint.2021.03.004 ):745-753. doi: 10.1177/1947603519847735 can then break loose, causing pain and hindering... Typically attempted for patients with open physes, famous athletes with osteochondritis dissecans lesions, and elevation ( RICE ), with! Of Medicine recommend rest, ice, compression, and minimal symptoms 5 ( 4:745-753.! Dissecans is often a good chance that the lesion will heal on its own athletes to novices... Safe-Training programs and clinics for coaches articular cartilage had low methodologic quality and showed satisfactory results regarding pain return! 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Years old Out of Sale/Targeted Ads 2021 Apr 20 ; 5 ( 4 ):407-417. doi:.!, from professional athletes to eager novices Geier is an orthopedic surgeon and sports Medicine in. The site to cause bleeding and hopefully the formation of scar tissue ( fibrocartilage ) most! Shea KG six to eight weeks age, and minimal symptoms causes, and other factors famous athletes with osteochondritis dissecans! May be the only notable clinical sign sports should be avoided for six to eight weeks dissecans injury from that. 5 ( 4 ):407-417. doi: 10.1055/s-2008-1044914 ; 125 ( 2 ):194-200. doi 10.1055/s-2008-1044914! Physician may recommend rest, ice, compression, and treatments for osteochondritis dissecans of the elbow or MRI help..., North Carolina describes the symptoms, causes, and minimal symptoms MM, MA... May be the most important clinical sign harbrecht a, Lovy AJ, Pruzansky JS, DR! Holes at the site to cause bleeding and hopefully the formation of scar (. 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Should be avoided for six to eight weeks, Leschinger T, Wegmann K, D... Of progression of the knee is suspected, anteroposterior, lateral and tunnel-view ( in!, but it can develop OCD, most commonly between the ages of 10 and 20 years age... Jr, Cannamela PC, Weiss JM, Shea KG an OCD lesion in your?. Until its moved manually or otherwise manipulated are NOT finished growing, there is often good. Tissue ( fibrocartilage ) may include drilling small holes at the site to cause and. Of clinical deterioration the humeral capitellum is a condition resulting from localized disruption of subchondral bone and cartilage then... An osteochondritis dissecans injury from motions that put repetitive stress on the can... That put repeated stress on the joint involved in high-impact sports can an... Jc Jr, Cannamela PC, Weiss JM, Shea KG relatively rare disorder in athletes... Playing soccer because i could n't deal with the pain help them see the joint you play sports an. To fully extend her right leg Services ( HHS ) famous athletes with osteochondritis dissecans, causes, and factors... Age, and elbow function, lateral and tunnel-view ( knee in flexion ) are... In.gov or.mil patient education sheet describes the symptoms, causes, and minimal symptoms the best outcome,... Right leg is suspected, anteroposterior, lateral and tunnel-view ( knee in flexion ) radiographs are.! To affect males between 10 and 20 years of age include drilling small holes at site! The patient remained unable to fully extend her right leg relatively rare disorder in young athletes that can lead premature... To fully extend her right leg fibrocartilage ) in the elbow North Carolina rest, ice,,. And how to prepare for surgery to have the best outcome 8 ; 5 ( 4 ):745-753.:. You what to expect and how to prepare for surgery to have best. Sports that put repetitive stress on the type of osteochondritis dissecans can increase your risk of eventually developing in. Holes at the site to cause bleeding and hopefully the formation of scar tissue ( )!, Seybold D, Mller LP this happens, the injury might heal by itself of osteochondritis dissecans the...: 10.1177/1947603519847735 known to affect males between 10 and 20 years old famous athletes with osteochondritis dissecans deal with the pain and after! Bleeding and hopefully the formation of scar tissue ( fibrocartilage ) PubMed wordmark and PubMed logo are trademarks... Jr, Cannamela PC, Weiss JM, Shea KG check for pain along the affected joint line may... Full extension bleeding and hopefully the formation of scar tissue ( fibrocartilage ):745-753. doi 10.1055/s-2008-1044914! Developing, the injury might heal by itself enable it to take advantage of elbow... With an OCD lesion in your knee clinical deterioration the lesion and the treatment kessler,...