The primary risk factor for developing osteochondral lesions in the elbow is overuse, especially with activities that place significant compressive forces across the elbow. Keywords: capitellum, elbow, MRI, osteochondritis dissecans, pediatric, sports. Am J Sports Med. Arthroscopic Articular Reconstruction of Capitellar Osteochondral Defects. MRI findings of OCD instability of the elbow include an osteochondral defect, intraarticular body, overlying cartilage changes, subchondral bone disruption, and rim of high signal intensity on T2-weighted MR images. Osteochondral lesions of the elbow are injuries that disrupt the cartilage and subjacent bone, and they most commonly involve the capitellum. Osteochondritis dissecans (OCD or OD) is a joint disorder primarily of the subchondral bone in which cracks form in the articular cartilage and the underlying subchondral bone. Osteochondritis dissecans (OCD) is a condition that develops in joints, most often in children and adolescents. Osteochondral lesions are acquired, potentially reversible injuries of the subchondral bone with or without associated articular cartilage involvement. This allows us to treat the bone defect without affecting the cartilage. The osteochondral graft plugs are applied with a press-fit effect, thus no fixation is necessary. 2015 Jan;7(1):19-26. Terminology. Preoperative magnetic resonance imaging scan of right elbow showing a large, uncontained osteochondral defect of the capitellum with a compromised lateral buttress (arrow). Learning proper mechanics may also help reduce injury. Injury results in delamination and potential sequestration of the affected bone. Too much throwing is harmful; pitch count limits should be observed especially in young players. (SAE07SM.80) A 12-year-old Little League pitcher reports lateral elbow pain and “catching.” Examination reveals painful pronation and supination and tenderness over the lateral elbow. For small-sized defects with intact cartilage, our treatment of choice is Retrograde Drilling of the lesion and filling it with a special bone cement. 2015 Oct;43(10):2452-8. doi: 10.1177/0363546515594448. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. Isolated lesions of cartilage or subchondral bone are not considered an OCD 6.. Section … Keywords: Osteochondral defect, Elbow, Particulated juvenile cartilage transfer Introduction Post-traumatic arthritis of the upper extremity is a difficult problem to treat in younger patients as they have higher physical demands, activity level, and longer life expectancy. In about 8 weeks, the plugs heal and we start strengthening. Early elbow and knee motion is encouraged with braces. This lesion was ultimately treated with osteochondral allograft transplantation. Osteochondral defect is a broad term that describes the morphological change of a localized gap in the articular cartilage and subchondral bone 5.It is often used synonymously with osteochondral injury/defect and in the pediatric population. Iyengar JJ, Grantham, Byrum, Ahmad CS: The Curveball as a Risk Factor for Injury: A Systematic Review, Sports Health, Sports Health. Although an association with mechanical and traumatic factors has b … Then same size holes are drilled in the elbow cartilage defect. OCD usually causes pain during and after sports. Radiographs are shown in Figures 22a and 22b. It occurs when a small segment of bone begins to crack and separate from its surrounding region due to a lack of blood supply. Epub 2015 Aug 13. This would be the optimal scenario. Treatment depends upon the size of the osteochondral defect and the condition of the overlying cartilage. 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