What are osteochondritis dissecans?

Osteochondritis dissecans (OCD) of the elbow is a condition most commonly seen in young athletes who participate in sports with repeated overhead motion, such as baseball or softball, gymnastics, weightlifting, and tennis. Repetitive stress to the elbow joint during these activities can result in injury to the underlying bone and cartilage.

Injured bone and cartilage may become unstable and break into the joint without treatment. Long-term consequences may include worsening elbow function and arthritis.

What are the symptoms of osteochondritis dissecans?

The most common symptom of elbow OCD is pain, which is often worse following activity. Over time, elbow discomfort can become continuous, and patients may develop other symptoms such as:

• Swelling or stiffness
• Difficulty straightening the elbow joint fully
• Pain or stiffness in the joint, particularly after physical activity. The joint may feel as if it's "locking," "catching," or "giving way." The symptoms of osteochondritis dissecans can mirror those of other joint injuries, so your child must consult a physician for proper diagnosis and treatment.

What causes osteochondritis dissecans?

Young athletes, especially those who play sports that require repeated actions that stress the joints, can suffer an OCD injury.

Gymnastics, squash, tennis, baseball, and weightlifting are sports that can increase the risk of osteochondritis dissecans of the elbow.

How is osteochondritis dissecans diagnosed?

To diagnose OCD of the elbow, an orthopedic specialist will ask questions about your child’s symptoms and perform a specialized physical exam of the elbow. An X-ray or MRI is often taken to see better and assess the joint.

How is osteochondritis dissecans treated?

In some patients, stable injuries can be treated without surgery. This non-surgical treatment consists of a complete rest of the affected elbow and physical therapy.

Surgical treatment of osteochondritis dissecans may be necessary if the bone or cartilage is unstable, has broken off loose fragments into the joint, or if rest and physical therapy were not successful at relieving pain.

Surgery

If the decision is made to pursue surgical treatment, individualized planning will help select the best techniques to treat your child’s injury. These may include:

• Drilling small holes into underlying bone to stimulate healthy cells and healing
• Removing or securing loose fragments
• Replacing the injured bone and cartilage with healthy tissue taken from elsewhere in the body

OATS Procedure

OATS, or osteochondral autologous transplantation surgery, is one treatment option for specific OCD injuries. The procedure involves replacing injured bone and cartilage in the elbow with healthy tissue (graft) taken from another part of the body, such as the side of the knee.

After surgery, your child will be placed into a long-arm cast for 2 to 3 weeks. No crutches are required for the knee. Physical therapy, including strengthening and range of motion exercises, will help your child progress toward a gradual return to sports.

How long will the required time to heal from osteochondritis in the elbow be?

Your recovery timeline depends on the severity of the injury you have sustained.

Even though the majority of such fractures are minor and heal in due course, some need surgical intervention and a protracted recovery period.

Even relatively mild OCD usually requires at least several months to recover from fully. If surgery is required, returning to sport and other physical activities can require around 6 months. Returning to activity too soon after surgery, particularly sports, risks re-injury and permanent damage.

Usually, there is no long-term harm to the elbow joint as long as OCD of the elbow heals fully.

What is the long-term outlook?

After the elbow is completely healed, your child can gradually return to sports – usually around 6 months after surgery.

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