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