Osteochondritis Dissecans of Smaller Joints: The Elbow

Abstract

This review presents the current understanding of the etiology, pathogenesis, and how to diagnose and treat osteochondritis dissecans (OCD) at the elbow joint followed by an analysis of particular characteristics and outcomes of the treatment. OCD is seen in patients with open growth plates (juvenile OCD [JOCD] and in adults [AOCD] with closed growth plates [adult OCD). The etiology at smaller joints remains as unclear as for the knee. Mechanical factors (throwing activities [capitulum] seem to play an important role. Clinical symptoms are unspecific. Thus, imaging techniques are most important for the diagnosis. In low-grade and stable lesions, treatment involves rest and different degrees of immobilization until healing. When surgery is necessary, the procedure depends on the OCD stage and on the state of the cartilage. With intact cartilage, retrograde procedures are favorable while with damaged cartilage, several techniques are used. Techniques such as drilling and microfracturing produce a reparative cartilage while other techniques reconstruct the defect with osteochondral grafts or cell-based procedures such as chondrocyte implantation. There is a tendency toward better results when reconstructive procedures for both the bone and cartilage are used. In addition, comorbidities at the joint have to be treated. Severe grades of osteoarthritis are rare.

Osteochondral Lesions of the Talus: A Review on Talus Osteochondral Injuries, Including Osteochondritis Dissecans

“…As for OLC/OCD at the knee joint or elbow joint 44,45 symptoms of OCL/OCD lesions are not specific and often vague. Most of the patients report on a diffuse ankle pain, probably in combination with swelling or blocking.…”

Detection of Elbow OCD in the Ultrasound Image by Artificial Intelligence Using YOLOv8

“…Baseball pitching can produce excessive stress on the anterior part of the capitellum, where most OCD lesions in throwing athletes are found. Mechanical conditions may play a role in elbow OCD, and bone bruises may be a precursor to an OCD lesion [3]. In the early stages of OCD, symptoms are infrequent, and conservative treatment is usually effective.…”

Preoperative Evaluation and Surgical Simulation for Osteochondritis Dissecans of the Elbow Using Three-Dimensional MRI-CT Image Fusion Images

“…Osteochondritis dissecans of the elbow (OCD) is a rare intra-articular osteochondral lesion that is associated with overhead throwing sports [ 1 , 2 , 3 , 4 , 5 ]. The subchondral bone and articular cartilage of the humeral capitellum are affected, and several possible causes, including repetitive microtrauma and genetic factors, are implicated [ 3 , 4 , 6 , 7 ].…”

“…Osteochondritis dissecans of the elbow (OCD) is a rare intra-articular osteochondral lesion that is associated with overhead throwing sports [ 1 , 2 , 3 , 4 , 5 ]. The subchondral bone and articular cartilage of the humeral capitellum are affected, and several possible causes, including repetitive microtrauma and genetic factors, are implicated [ 3 , 4 , 6 , 7 ]. Although the stability and size of the lesion are considered important factors impacting lesion severity [ 6 , 8 , 9 , 10 ], no single imaging modality can adequately predict lesion severity [ 11 , 12 , 13 , 14 , 15 , 16 , 17 ], thereby presenting a challenge to elbow surgeons.…”