Epub 2015 Aug 13. Although an association with mechanical and traumatic factors has b … The osteochondral graft plugs are applied with a press-fit effect, thus no fixation is necessary. 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. Osteochondritis dissecans (OCD) is a condition that develops in joints, most often in children and adolescents. 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. 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. An osteochondral defect that is in the early stages may be suitable for a repair technique to keep the native bone and cartilage. 2015 Oct;43(10):2452-8. doi: 10.1177/0363546515594448. This requires a detailed evaluation to be performed to assess the integrity of the remaining cartilage, the underlying bone and to look for evidence of healing capacity. 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. Section … Osteochondral lesions are acquired, potentially reversible injuries of the subchondral bone with or without associated articular cartilage involvement. Isolated lesions of cartilage or subchondral bone are not considered an OCD 6.. This allows us to treat the bone defect without affecting the cartilage. Then same size holes are drilled in the elbow cartilage defect. Learning proper mechanics may also help reduce injury. Too much throwing is harmful; pitch count limits should be observed especially in young players. Preoperative magnetic resonance imaging scan of right elbow showing a large, uncontained osteochondral defect of the capitellum with a compromised lateral buttress (arrow). This lesion was ultimately treated with osteochondral allograft transplantation. (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. Early elbow and knee motion is encouraged with braces. Iyengar JJ, Grantham, Byrum, Ahmad CS: The Curveball as a Risk Factor for Injury: A Systematic Review, Sports Health, Sports Health. Injury results in delamination and potential sequestration of the affected bone. 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. Radiographs are shown in Figures 22a and 22b. Am J Sports Med. Terminology. Treatment depends upon the size of the osteochondral defect and the condition of the overlying cartilage. OCD usually causes pain during and after sports. Keywords: capitellum, elbow, MRI, osteochondritis dissecans, pediatric, sports. In about 8 weeks, the plugs heal and we start strengthening. In later stages of the disorder there will be swelling of the affected joint which catches and locks during movement. 2015 Jan;7(1):19-26. The primary risk factor for developing osteochondral lesions in the elbow is overuse, especially with activities that place significant compressive forces across the elbow. This would be the optimal scenario. 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