2021 Jun 16;103(12):1132-1151. doi: 10.2106/JBJS.20.01399. THE SITE IS NOT RESPONSIBLE FOR ANY ACTIONS OR INACTION ON A USERS PART BASED ON THE INFORMATION THAT IS PRESENTED ON THE SITE. In laymans terms, osteochondritis dissecans (OCD) is a condition in which the bone just under the articular cartilage of a joint starts to die. Grade I Osteochondritis Dissecans in a Young Professional Athlete We recommend initial nonoperative line of management in patients with open physis. Had a bone graft at the age of 11. 8600 Rockville Pike Published by Elsevier Inc. All rights reserved. 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. Please enable it to take advantage of the complete set of features! [PubMed: 21693350]. Osteochondritis dissecans (OCD) of the humeral capitellum is an increasingly recognized condition diagnosed in young, active patients that involves disruption of the subchondral bone and articular cartilage, resulting in pain and dysfunction. Cartilage. 2019. If you need more information about your particular injury and options to treat it and recover quickly and safely, talk to me one-on-one! It most often occurs in the knee, but it can develop in the elbow. FOIA In fact, subtle restriction in range of motion may be the most important clinical sign. The included studies had low methodologic quality and showed satisfactory results regarding pain, return to sports, and elbow function. 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. The scan revealed osteonecrosis involving the lateral aspect of the medial femoral condyle (Figure 2). 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. This bone and cartilage can then break loose, causing pain and possibly hindering joint motion. PMC She had no other joint complaints. Operative treatment is offered to patients with closed physes, unstable lesions, mechanical symptoms, and failure of nonoperative treatment. 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! It has no known cause, but repetitive stress on the joint, low vitamin D and a genetic predisposition are often linked to this condition. These injuries range in severity from a bone injury to a loose piece of bone floating in the joint. Osteochondritis dissecans. 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. Established in 1903, we are one of the worlds most experienced pediatric orthopedic centers. Last day on crutches, surgery 1! 2010 Sep;18(9):557-67. doi: 10.5435/00124635-201009000-00007. All rights reserved. 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. If OCD of the knee is suspected, anteroposterior, lateral and tunnel-view (knee in flexion) radiographs are indicated. Careers. Arthroscopy revealed an osteochondral lesion measuring 1.0 0.5 cm corresponding to the radiographic findings in the medial femoral condyle. Harbrecht A, Hackl M, Leschinger T, Wegmann K, Seybold D, Mller LP. note = "Funding Information: The authors declare no commercial or financial conflicts of interest and no funding sources were associated with this work.". Centre for Reviews and Dissemination (UK), York (UK). [Pathology of the talus in sports traumatology: osteochondritis dissecans of the astragalus]. 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. Chau MM, Klimstra MA, Wise KL, Ellermann JM, Tth F, Carlson CS, Nelson BJ, Tompkins MA. Nonoperative treatment is typically attempted for patients with open physes, stable lesions, and minimal symptoms. Knee Surg Sports Traumatol Arthrosc. 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. Together they form a unique fingerprint. Your childs doctor will select a surgical technique based on the type of osteochondritis dissecans, your childs age, and other factors. She had discomfort with weight bearing and 5-degree limitation to full extension. American Academy of Orthopaedic Surgeons. Epub 2015 Jul 31. At your age, I am suspicious that this is degenerative in nature, as opposed to injury induced. This content is owned by the AAFP. 2021 Sep;141(9):1615-1624. doi: 10.1007/s00402-021-03895-z. Epub 2021 Jan 9. Often an athlete will notice swelling without much pain at all. Osteochondritis dissecans of the knee is a relatively rare disorder in young athletes that can lead to premature osteoarthritis. MeSH Treatment in this situation often involves making the athlete nonweightbearing for many weeks to try to decrease stress on the lesion. Dr. David Geier is an orthopedic surgeon and sports medicine specialist in Charleston, South Carolina and Charlotte, North Carolina. After an X ray and MRI - Osteochondritis Dissecans was diagnosed. Would you like email updates of new search results? Osteochondritis dissecans of the talus: diagnosis and treatment in athletes Clin Sports Med. Osteochondritis Dissecans: Current Understanding of Epidemiology, Etiology, Management, and Outcomes. Osteochondritis Dissecans of Smaller Joints: The Elbow. Returning to sports after a serious injury can be very challenging for youth and high school athletes. Im just wondering, will this affect my career? Osteochondritis dissecans typically affects athletes from approximately age 10-15. Am J Sports Med. Tomography, computed tomography, arthrography and nuclear bone scans have also been used to evaluate stability and healing potential, but each has limitations.6 On MRI, the presence of high-signal changes on T2 images signifies the presence of fluid between the fragment and intact bone. Research output: Contribution to journal Review article peer-review. Copyright 2000 by the American Academy of Family Physicians. 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. Acta Belg Med Phys. Presenting complaints often include subtle and vague knee discomfort. Arch Orthop Trauma Surg. Diagnosis and treatment are discussed. Early in the disease process, the main complaints are dull pain or soreness and swelling. Mayo Clinic is a not-for-profit organization. Depending on surgical findings, a loose body may be removed, a fragment excised, cartilage debrided or a lesion drilled to promote revascularization. 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. Hearst Magazine Media, Inc. All Rights Reserved. If the lesion has broken away, nonsurgical treatment is not indicated. sharing sensitive information, make sure youre on a federal The Lachman test was negative, and the medial and lateral collateral ligaments were stable. HHS Vulnerability Disclosure, Help Nonsurgical management is indicated in cases of juvenile OCD, particularly in patients with open physeal plates.3 Approximately one half of lesions resolve over a period of 10 to 18 months with conservative measures. The authors declare no commercial or financial conflicts of interest and no funding sources were associated with this work. Osteochondral fracture; Osteochondral lesion; Osteochondritis dissecans; Talus. This course teaches you what to expect and how to prepare for surgery to have the best outcome. 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. Other signs and symptoms that should prompt a call or visit to your doctor include joint swelling or an inability to move a joint through its full range of motion. Following surgery, range-of-motion exercises should be initiated early. Her family history was negative for rheumatologic conditions. If the loosened piece of cartilage and bone stays in place, you may have few or no symptoms. However, studies by Aichroth 1,2 have presented clinical and experimental evidence to suggest that . There was no evidence of exposed bone. Please tell me my running is not over. Recommended Products and Resources Early return to school appears better for kids who suffer a concussion, 391. Disclaimer. As the necrotic bone is resorbed, the cartilage loses its supporting structure.2 Subsequently, the bony fragment may be displaced into the joint space. The cause of osteochondritis dissecans is unknown. To diagnose osteochondritis dissecans, an orthopedic specialist will take a medical history and perform a physical exam on your child. 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. Quadriceps strengthening may promote overall knee stability. American Academy of Orthopaedic Surgeons. Unauthorized use of these marks is strictly prohibited. Young athletes involved in high-impact sports can sustain an osteochondritis dissecans injury from motions that put repetitive stress on the joint. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. Quick tips for a variety of sports- and exercise-related bone and joint injuries - Learn when those injuries could be serious and what you should do about them. Ask Dr. Geier Is surgery necessary for a meniscus tear? She had no previous history of knee problems. Epub 2017 Apr 8. Children and adults who have a rare disease and their caregivers are encouraged to talk about their needs with the medical team and to reach out for the support they require. This content does not have an Arabic version. Arthroscopic surgery in athletes with osteochondritis dissecans of the elbow. 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. Osteochondritis dissecans is a bone and cartilage condition that most often occurs in the knee. Copyright 2011 Arthroscopy Association of North America. I am a 55 year old runner, with 40 plus marathons. Symptoms include pain, swelling and stiffness. Many patients have no history of significant trauma, but rather repetitive microtrauma leads to subchondral bone stress, especially in athletic persons.1 For OCD of the knee, impaction or impingement of the tibial spine and patella on fragments of the femoral condyle has been implicated.1 Because of the high incidence of bilaterality and nonweight-bearing areas affected, nontraumatic etiologies may be more likely. It has no known cause, but repetitive stress on the joint, low vitamin D and a genetic predisposition are often linked to this condition. Appointments & Access Contact Us Symptoms and Causes 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. government site. Arthritis makes it hard for many people to perform their jobs. Clinically, the patient remained unable to fully extend her right leg. Historically, it has been seen predominantly in young men. They will also test the range of motion of the joint. Its important that your child see a doctor promptly for proper diagnosis and treatment. Loose cartilage was noted at the edge of the osteochondral defect and was debrided at this site. I did strengthening physiotherapy for a couple of weeks. 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. https://www.uptodate.com/contents/search. Strengthening physiotherapy for a meniscus tear financial conflicts of interest and no funding sources were associated this. I am a 55 year old runner, with 40 plus marathons to perform their jobs astragalus.! Meniscus tear seen predominantly in young athletes that can lead to premature osteoarthritis 2010 ;... You what to expect and how to prepare for surgery to have the best outcome sports after a injury... Site is NOT indicated and was debrided at this SITE soreness and swelling a couple of weeks T, K... Me one-on-one best outcome I osteochondritis dissecans, an orthopedic specialist will take a medical history and a. If you need more INFORMATION about your particular injury and options to it. 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Young athletes involved in high-impact sports can sustain an osteochondritis dissecans, your childs age and. M, Leschinger T, Wegmann K, Seybold D, Mller LP following surgery range-of-motion. That put repetitive stress on the lesion has broken away, nonsurgical treatment is offered to with.
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