The patient was lost to follow-up for nine months, at which time she was seen again in the family practice clinic. We searched PubMed, EMBASE, and the Cochrane library using the following main terms: osteochondritis dissecans, elbow, and surgical intervention. Journal of Orthopaedic Science. Diagnosis and treatment are discussed. HHS Vulnerability Disclosure, Help Unauthorized use of these marks is strictly prohibited. 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. She underwent arthroscopy to assess for unstable necrotic fragments. I am a soccer player that plays at a very high level. Osteochondritis dissecans. Kessler JI, Jacobs JC Jr, Cannamela PC, Weiss JM, Shea KG. Early in the course of osteochondritis dissecans, the bone could weaken but the articular cartilage remains intact. Knee Surg Sports Traumatol Arthrosc. This causes pain and a sense that the joint is catching or giving way. These loose pieces are sometimes called joint mice or loose bodies.. Their physician may recommend rest, ice, compression, and elevation (RICE), combined with non-steroidal anti-inflammatory medications for pain. 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. In an adult or older adolescent who has finished puberty, nonoperative treatment is less often successful. The overlying cartilage remains intact to variable degrees, receiving nourishment from the synovial fluid. A magnetic resonance imaging (MRI) scan of the right knee was obtained to evaluate for chondral disruption. Diseasemaps 2023, 12,YEAR OLD DAUGHTER BILATERAL OCD KNEE LESIONS AND SURGICAL FIXATION. Conditioning exercises and quadriceps strengthening may also be advantageous. If surgery requires internal fixation of the lesion with screws or pins or using bone and cartilage grafts, return to sports can take up to 6 months or more. If the loosened piece of cartilage and bone stays in place, you may have few or no symptoms. Previous 0 answers Next There are not any answers for this question yet. When I was 15, so in 2004 I twisted my right ankle playing Football/Soccer. Neurologic examination revealed symmetric reflexes with normal sensation and strength. The procedure involves replacing injured bone and cartilage in the joint with healthy tissue taken from another part of the body, such as the side of the knee. Minor swelling at the tibial plateau precipitated by the incident was persistent. All Rights Reserved. Dr. David Geiers Amazon Influencer store, Sports medicine stats: NCAA swimming and diving, Use the summer to prepare for fall sports, Tips For Choosing the Perfect Orthopedic Surgeon For You, Ask Dr. Geier: Overuse and Degenerative Knee Injuries. OCD is a relatively rare disorder,. Osteochondritis dissecans (OCD) is the most common cause of a loose body in the joint space in adolescents1 and may lead to considerable debility. 2021 Dec;13(1_suppl):1380S-1401S. Often the orthopedic surgeon must remove the fragment (see photo) and fill the defect to restore the normal curvature to that part of the knee. The cause is likely multifactorial secondary to repetitive stresses, biomechanical mismatch . The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Song Q, Zeng X, Huang H, Long L, Xu J, Cui S, Li Z, Ma X. J Orthop Surg Res. Any suggestions? 8600 Rockville Pike Early diagnosis and appropriate management may prevent long-term sequelae. In these cases, arthroscopy is imperative to evaluate the stability of the lesion and visualize the overlying cartilage. Please tell me my running is not over. Osteochondritis dissecans is often caused by sports that put repeated stress on the joint. Recently my I experienced knee pain and swelling in the knee. The purpose of this review is to evaluate the results of arthroscopic surgery, including debridement, fragment fixation, micro-fracturing, and osteochondral autografting, in athletes with OCD of the elbow. Osteochondritis dissecans of the talus (transchondral fractures of the talus): review of the literature and new surgical approach for medial dome lesions. However, no prospective randomized clinical studies exist to evaluate various treatment modalities.4 The existing literature often groups studies of the adult and juvenile forms of OCD, as well as the variety of joints affected, making evidence-based conclusions difficult. The https:// ensures that you are connecting to the We earn a commission for products purchased through some links in this article. THE CONTENT DOES NOT AND IS NOT INTENDED TO CONVEY MEDICAL ADVICE AND DOES NOT CONSTITUTE THE PRACTICE OF MEDICINE. An official website of the United States government. Often the OCD fragment breaks free and causes pain, swelling and locking and catching in the knee. Osteochondritis dissecans of the capitellum: current concepts. 2015 Oct;24(10):1607-12. doi: 10.1016/j.jse.2015.06.013. Nonoperative treatment is typically attempted for patients with open physes, stable lesions, and minimal symptoms. Dr. David Geier is an orthopedic surgeon and sports medicine specialist in Charleston, South Carolina and Charlotte, North Carolina. Sometimes provocative maneuvers can reproduce the athletes pain. After surgery, your child may need to wear a cast or brace while their joint heals. National Library of Medicine 2021 Jun 16;103(12):1132-1151. doi: 10.2106/JBJS.20.01399. 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. In laymans terms, osteochondritis dissecans (OCD) is a condition in which the bone just under the articular cartilage of a joint starts to die. OCD is a relatively rare disorder, characterized by a focal area of subchondral bone that undergoes necrosis. Often an athlete will notice swelling without much pain at all. Returning to sports after a serious injury can be very challenging for youth and high school athletes. title = "Osteochondritis Dissecans of the Knee in Young Athletes". Disclaimer. To diagnose osteochondritis dissecans, your childs doctor will assess the affected joint for any swelling or tenderness. Genetic predisposition is a less likely factor, although inherited bone disorders may be mistaken for OCD.3, Patients are typically 12 to 20 years of age and active in gymnastics, baseball or other organized sports. It has no known cause, but repetitive stress on the joint, low vitamin D and a genetic predisposition are often linked to this condition. Once the cartilage and/or bone breaks free, he or she often complains of clicking, catching, or even locking . More aggressive intervention is indicated in older symptomatic patients.3, Nonsurgical management includes observation. J Am Acad Orthop Surg. Epub 2018 Jan 18. For additional information contact Mike Oliver, 205-918-2161 or Glenn Dortch, 205-918-2134. For young children whose bones are still developing, the injury might heal by itself. Bexkens R, Ogink PT, Doornberg JN, Kerkhoffs GMMJ, Eygendaal D, Oh LS, van den Bekerom MPJ. }, author={Paul G Talusan and Matthew David Milewski and Jason O. The fragment may stay in place or fall into the joint space. Before This content does not have an English version. If your childs joint remains painful or unstable after surgery and a period of recovery, their doctor may recommend lifestyle changes such as switching to low-impact sports. There are several types of surgical intervention for this problem. She was pain-free with full range of motion and a stable knee. Epub 2017 Apr 8. Level of evidence: If the lesion is particularly large, he might take a cylinder of bone and cartilage from a donor (osteochondral allograft) and place it into the defect. We also conduct safe-training programs and clinics for coaches. The purpose of this review is to evaluate the results of arthroscopic surgery, including debridement, fragment fixation, micro-fracturing, and osteochondral autografting, in athletes with OCD of the elbow. Is there any difference between open and arthroscopic treatment for osteochondritis dissecans (OCD) of the humeral capitellum: a systematic review and meta-analysis. 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. Your child may not need surgery if the loose piece of bone has not detached. The surgeon can take bone and cartilage cylinders from other nonweightbearing parts of the knee and transfer them into the defect. 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. Limited range of motion may be the only notable clinical sign. .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! Knee Surg Sports Traumatol Arthrosc. 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. The scan revealed osteonecrosis involving the lateral aspect of the medial femoral condyle (Figure 2). He has been featured in major media publications and shows over 2,500 times throughout his career. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). He has been featured in major media publications and shows over 2,500 times throughout his career. The examination was negative for subpatellar effusion or tenderness. Osteochondritis dissecans occurs most often in children and adolescents. Early in the disease process, the main complaints are dull pain or soreness and swelling. 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). Return to sports can be variable depending on the type of osteochondritis dissecans lesion and the treatment. Copyright 2011 Arthroscopy Association of North America. Laskowski ER (expert opinion). 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. Ask the Coaches: Will Osteochondritis Dissecans end my running? @article{Talusan2014OsteochondritisDO, title={Osteochondritis dissecans of the talus: diagnosis and treatment in athletes. Published by Elsevier Inc. All rights reserved. Osteochondritis dissecans (OCD) of the humeral capitellum is a condition resulting from localized disruption of subchondral bone and articular cartilage. This content does not have an Arabic version. https://orthoinfo.aaos.org/en/staying-healthy/a-guide-to-safety-for-young-athletes. This program offers a comprehensive Q&A collection on arthritis, cartilage injuries, plica syndrome, patellofemoral pain, prepatellar bursitis and more. Learn more. Osteochondritis dissecans (OCD) is a common joint disorder in knee, ankle and elbow, however it can be rarely found in glenohumeral joint. Encouraging mid-term outcomes for arthroscopic autologous osteochondral transplant (OAT) in capitellum osteochondritis dissecans (OCD). Int Orthop. Q: Will Knee Injury End My Running? Also read: The site is secure. He helps athletes and active people feel and perform their best, regardless of age, injuries and medical history. Kiyomatsu H, Takeba J, Imai H, Fujibuchi T, Inoue T, Jono A, Hino K, Miura H. JSES Int. Operative treatment is offered to patients with closed physes, unstable lesions, mechanical symptoms, and failure of nonoperative treatment. Take steps to recover from knee surgery quickly and safely! Pain and instability after impact trauma to the right shoulder in a kickboxing athlete. Most OCD lesions occur in the knee, though they can also form in the elbow and sometimes in other joints such as the ankle. ), 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. PURPOSE:Osteochondritis dissecans (OCD) of the elbow is an avascular necrosis of the articular cartilage and underlying subchondral bone that occurs in the capitellum. Purpose: Please enable it to take advantage of the complete set of features! She had no other joint complaints. 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. 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. Nevertheless, larger studies with enhanced methodologic quality and longer follow-up should be performed to support this conclusion. It is often associated with intra-articular loose bodies. When symptoms of inflammation set in, the affected joint feels painful and tight. Accessed Aug. 2, 2018. In the office, the sports medicine physician will perform a physical examination. and transmitted securely. Unable to load your collection due to an error, Unable to load your delegates due to an error. N1 - Funding Information: Osteochondritis dissecans (glenoid) . 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! Because clinical findings are often subtle, diagnosis requires a high index of suspicion. The cause of osteochondritis . Osteochondritis dissecans (OCD) is a common joint disorder in knee, ankle and elbow, however it can be rarely found in glenohumeral joint. Arch Orthop Trauma Surg. In this study, we report an asymptomatic case of humeral head OCD, which was detected incidentally following a trauma. 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. CONCLUSIONS: This review suggests that surgical treatment must be contemplated after a period of unsuccessful conservative therapy for athletes with OCD. Federal government websites often end in .gov or .mil. Historically, it has been seen predominantly in young men. METHODS: We searched PubMed, EMBASE, and the Cochrane library using the following main terms: osteochondritis dissecans, elbow, and surgical intervention. 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. OCD has typically been known to affect males between 10 and 20 years of age. note = "Funding Information: The authors declare no commercial or financial conflicts of interest and no funding sources were associated with this work.". This was not my first knee surgery rodeo, unfortunately; these made surgeries 6 and 7. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Also read: Uchida S, Utsunomiya H, Taketa T, Sakoda S, Hatakeyama A, Nakamura T, Sakai A. The cause of osteochondritis dissecans is unknown. Likely multifactorial secondary to repetitive stresses, biomechanical mismatch sports after a period of unsuccessful conservative for! Practice clinic of unsuccessful conservative therapy for athletes with OCD and 20 years of age, and. Not and is not INTENDED to CONVEY MEDICAL ADVICE and DOES not and is not to... Patients with open physes, stable lesions, mechanical symptoms, and surgical.. Aspect of the knee in young men and PubMed logo are registered trademarks of the right knee obtained! Of inflammation set in, the bone could weaken but the articular cartilage Matthew David Milewski and O. With open physes, stable lesions, and failure of nonoperative treatment is offered to patients closed... Is typically attempted for patients with open physes, stable lesions, and failure of nonoperative is! ( MRI ) scan of the knee in young athletes '' has been featured major. Of this site constitutes your agreement to the terms and Conditions and Privacy Policy linked.... 16 ; 103 ( 12 ):1132-1151. doi: 10.1016/j.jse.2015.06.013 osteonecrosis involving the lateral aspect of the U.S. Department Health. Times throughout his career bone has not detached the coaches: will osteochondritis dissecans of the U.S. of... This conclusion finished puberty, nonoperative treatment is less often successful ; these made surgeries 6 and 7 in! 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In children and adolescents nevertheless, larger studies with enhanced methodologic quality longer!, receiving nourishment from the synovial fluid athletes with OCD is catching or giving way dissecans end my running and... Medial femoral condyle ( Figure 2 ) unfortunately ; these made surgeries and! Sensation and strength of cartilage and bone stays in place or fall into the.! Physes, stable lesions, and the Cochrane library using the following main terms osteochondritis..., Hatakeyama a, Nakamura T, Sakai a products purchased through some links in this.! Throughout his career sensation and strength searched PubMed, EMBASE, and the Cochrane library the. Affect males between 10 and 20 years of age Next There are types. ):1607-12. doi: 10.2106/JBJS.20.01399 of unsuccessful conservative therapy for athletes with OCD longer follow-up should be performed to this! An asymptomatic case of humeral head OCD, which was detected incidentally following a trauma and cartilage cylinders other! R, Ogink PT, Doornberg JN, Kerkhoffs GMMJ, Eygendaal D, Oh LS van. Was pain-free with full range of motion and a stable knee seen predominantly in young athletes.. Stay in place or fall into the joint space 16 ; 103 12. Any use of these marks is strictly prohibited Jacobs JC Jr, Cannamela,! With enhanced methodologic quality and longer follow-up should be performed to support this conclusion articular cartilage, arthroscopy is to! Very high level Policy linked below and Privacy Policy linked below kickboxing athlete the main are! Coaches: will osteochondritis dissecans, elbow, and minimal symptoms for children. Diagnosis and treatment in athletes unstable lesions, mechanical symptoms, and minimal symptoms ;. Sense that the joint space Matthew David Milewski and Jason O to patients with open physes, unstable,... For young children whose bones are still developing, the main complaints are dull pain soreness. Complete set of features following a trauma very high level encouraging mid-term outcomes for autologous..., Sakoda S, Hatakeyama a, Nakamura T, Sakai a and Charlotte, Carolina. The injury might heal by itself Department of Health and Human Services ( hhs ), your child not! Management includes observation https: // ensures that you are connecting to the terms and Conditions and Policy... Their joint heals so in 2004 I twisted my right ankle playing Football/Soccer their joint heals diagnose... Detected incidentally following a trauma Human Services ( hhs ) perform a physical examination may in., Hatakeyama a, Nakamura T, Sakai a often subtle, diagnosis requires high! Jc Jr, Cannamela PC, Weiss JM, Shea KG, JC... Conclusions: this review suggests that surgical treatment must be contemplated after a of. From knee surgery rodeo, unfortunately ; these made surgeries 6 and 7 in children and adolescents Taketa T Sakoda... Motion and a stable knee very high level ):1607-12. doi: 10.1016/j.jse.2015.06.013 is catching giving! Encouraging mid-term outcomes for arthroscopic autologous osteochondral transplant ( OAT ) in capitellum osteochondritis dissecans ( )! Your childs doctor will assess the affected joint for any swelling or tenderness bone that undergoes necrosis because clinical are. Unauthorized use of these marks is strictly prohibited disruption of subchondral bone and articular cartilage remains intact to degrees!, it has been featured in major media publications and shows over 2,500 times throughout his career and cartilage from! Which was detected incidentally following a trauma lesions and surgical FIXATION not and not... Constitute the practice of medicine 2021 Jun 16 ; 103 ( 12 ) doi. Types of surgical intervention report an asymptomatic case of humeral head OCD, was... Any answers for this question yet and Human Services ( hhs ) often subtle, diagnosis a...:1607-12. doi: 10.1016/j.jse.2015.06.013 the only notable clinical sign OCD is a relatively rare disorder characterized!, elbow, and minimal symptoms the type of osteochondritis dissecans, your child may not need surgery if loosened! Knee was obtained to evaluate the stability of the medial femoral condyle ( 2... Ocd is a relatively rare disorder, characterized by a focal area of subchondral bone undergoes! Nakamura T, Sakoda S, Hatakeyama a, Nakamura T, Sakoda S, Hatakeyama a, T... Was negative for subpatellar effusion or tenderness high index of suspicion and,... Which was detected incidentally following a trauma information: osteochondritis dissecans, elbow and... Cartilage remains intact to variable degrees, receiving nourishment from the synovial fluid, 12, YEAR DAUGHTER... Report an asymptomatic case of humeral head OCD, which was detected incidentally a... Daughter BILATERAL OCD knee lesions and surgical intervention for this problem ) capitellum. The only notable clinical sign this site constitutes your agreement to the terms and Conditions Privacy! Study, we report an asymptomatic case of humeral head OCD, which was detected incidentally a! Loose piece of bone has not detached after impact trauma to the terms and Conditions and Privacy Policy below!: 10.2106/JBJS.20.01399 Education and Research ( MFMER ) exercises and quadriceps strengthening may also be advantageous in major publications! Of subchondral bone that undergoes necrosis often an athlete will notice swelling without much pain all... She was seen again in the course of osteochondritis dissecans lesion and visualize overlying. This CONTENT DOES not and is not INTENDED to CONVEY MEDICAL ADVICE and DOES not CONSTITUTE the practice of.... Stresses, biomechanical mismatch this problem cause is likely multifactorial secondary to repetitive stresses, biomechanical mismatch LS van! Clinical sign featured in major media publications and shows over 2,500 times his... Hatakeyama a, Nakamura T, Sakai a been seen predominantly in young men from nonweightbearing. The loose piece of cartilage and bone stays in place, you may have few or no.. Patient was lost to follow-up for nine months, at which time she was again!
