Careers. Imaging studies are indicated for evaluation of clinical deterioration. Unauthorized use of these marks is strictly prohibited. The overlying cartilage remains intact to variable degrees, receiving nourishment from the synovial fluid. Osteochondritis dissecans (OCD) is a common joint disorder in knee, ankle and elbow, however it can be rarely found in glenohumeral joint. Osteochondritis dissecans can increase your risk of eventually developing osteoarthritis in that joint. Girls younger than 11 years of age and boys younger than 13 years of age have an excellent chance of resolution, while patients over 20 years of age tend to have poorer outcomes, and the likelihood of requiring surgical intervention is increased.1 Unstable lesions (stages III and IV) in patients with a closed physis have a particularly poor prognosis. Matthijs R.KrijnenM.D., Ph.D. Rudolf W.PoolmanM.D., Ph.D. W. Osteochondritis dissecans of the knee is a common disorder with an unknown cause. Osteochondritis dissecans of the glenoid: an analysis of grades, treatment, and outcomes. . 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. eCollection 2018 Dec. Arthroscopic fragment fixation using hydroxyapatite/poly-L-lactate Acid thread pins for treating elbow osteochondritis dissecans. NCI CPTC Antibody Characterization Program. Orthop J Sports Med. Learn more. Common knee injuries a young athlete can suffer. Bookshelf All Rights Reserved. However, no prospective randomized clinical studies exist to evaluate various treatment modalities.4 The existing literature often groups studies of the adult and juvenile forms of OCD, as well as the variety of joints affected, making evidence-based conclusions difficult. Should you play sports with an OCD lesion in your knee? 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. Radiographs were obtained after the limitation of extension was identified. Hearst Magazine Media, Inc. All Rights Reserved. The doctor will check for pain along the affected joint line and may order an x-ray or MRI to help them see the joint. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Depending on the joint that's affected, signs and symptoms of osteochondritis dissecans might include: If you have persistent pain or soreness in your knee, elbow or another joint, see your doctor. I was initially diagnosed with a Miniscus Fiscus at the age of 5. Sometimes provocative maneuvers can reproduce the athletes pain. The Lower Extremity Program offers comprehensive diagnosis and treatment for children with lower extremity disorders. Learn more about Hand and Orthopedic Upper Extremity Program, Technology & Innovation Development Office, difficulty fully straightening the arm or leg, feeling like the joint is locking, catching, or giving way, collection of fluid around the joint (water on the knee), drilling small holes in the underlying bone to stimulate healing, removing or securing loose fragments of bone, a procedure called osteochondral autologous transplantation surgery (OATS). [Pathology of the talus in sports traumatology: osteochondritis dissecans of the astragalus]. She was pain-free with full range of motion and a stable knee. Young athletes involved in high-impact sports can sustain an osteochondritis dissecans injury from motions that put repetitive stress on the joint. Results: Usually return to sports is not possible until the lesion has healed. If a period of no weight-bearing does not cause the lesion to heal, the surgeon can occasionally drill small holes into the bone arthroscopically to stimulate blood flow into it. Accessibility All OCD lesions evident on radiographs should be staged for stability with MRI. 2021 Dec;13(1_suppl):1380S-1401S. Learn more about Performing Artist Athletes Program. https://orthoinfo.aaos.org/en/staying-healthy/a-guide-to-safety-for-young-athletes. Appointments & Access Contact Us Symptoms and Causes Diagnosis and treatment of osteochondritis dissecans of the humeral capitellum. 393. For young children whose bones are still developing, the injury might heal by itself. She had no previous history of knee problems. She underwent arthroscopy to assess for unstable necrotic fragments. Treatment in this situation often involves making the athlete nonweightbearing for many weeks to try to decrease stress on the lesion. The Pediatric Sports Medicine Division provides comprehensive care to athletes of all ages and abilities, from professional athletes to eager novices. Following surgery, range-of-motion exercises should be initiated early. Dr. David Geier is an orthopedic surgeon and sports medicine specialist in Charleston, South Carolina and Charlotte, North Carolina. Other than the "clean out" surgery, each of these procedures will require a prolonged period of recovery. Osteochondritis dissecans of the knee is being seen with increased frequency in pediatric and young adult athletes and is thought to be, in part, owing to earlier and increasingly competitive sports participation. A magnetic resonance imaging (MRI) scan of the right knee was obtained to evaluate for chondral disruption. Early recognition is . sharing sensitive information, make sure youre on a federal The 9 selected articles were criticized by use of a quality assessment tool derived from the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group. Learning the proper mechanics and techniques of their sport, using the proper protective gear, and participating in strength training and stability training exercises can help reduce the chance of injury. This course teaches you what to expect and how to prepare for surgery to have the best outcome. Osteochondritis dissecans (OCD) in a young athlete Dr. David Geier is an orthopedic surgeon and sports medicine specialist in Charleston, South Carolina and Charlotte, North Carolina. Returning to sports after a serious injury can be very challenging for youth and high school athletes. Unable to load your collection due to an error, Unable to load your delegates due to an error. The diagnosis is made by radiographic examination, and magnetic resonance imaging has a key role in determining the stability of the lesion. The goal of activity modification is to allow symptom-free activities of daily living.1 Physical therapy may be initiated, including stretching and range-of-motion exercises. Is there any difference between open and arthroscopic treatment for osteochondritis dissecans (OCD) of the humeral capitellum: a systematic review and meta-analysis. Osteochondral fracture; Osteochondral lesion; Osteochondritis dissecans; Talus. 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. Nonoperative treatment is typically attempted for patients with open physes, stable lesions, and minimal symptoms. All rights reserved. eCollection 2021 Jan. Jafari D, Shariatzadeh H, Mazhar FN, Okhovatpour MA, Razavipour M. Injuries to the talus-neck fractures and osteochondral lesions (osteochondritis dissecans). Maruyama M, et al. By continuing you agree to the use of cookies. In a young athlete who has not finished his growth spurt, the surgeon might try a period of making him nonweightbearing and hold him out of sports.In this young population, nonoperative treatment is often successful to get the lesion to heal. Often the exam is unremarkable unless there is a loose piece to catch within the joint. The cause of osteochondritis . 2018;23:213. Osteochondritis dissecans of the talus is a subset of osteochondral lesions of the talus that also includes osteochondral fractures, avascular necrosis, and degenerative arthritis. Other times it is a free-floating piece of bone and cartilage that is removed and filled with cylinders of bone and cartilage from the athletes knee or from a donor. The Sports Ultrasound Clinic uses innovative technology to diagnose injuries of the joints, ligaments, and muscles. Your child may not need surgery if the loose piece of bone has not detached. Print Overview Osteochondritis dissecans (os-tee-o-kon-DRY-tis DIS-uh-kanz) is a joint condition in which bone underneath the cartilage of a joint dies due to lack of blood flow. This may include specialized manipulations of the joint, such as a Wilson test of the knee, to see if a particular rotation of the knee causes pain. Please tell me my running is not over. Click here to go to Dr. David Geiers Amazon Influencer store! Restoring normal anatomy to the femoral condyle of the knee through whatever means necessary nonoperative or operative is critical to allow normal daily activities and exercise later in life. Children with osteochondritis dissecans should receive medical treatment right away. Common complaints include sensations of catching and giving way,4 as well as the inability to fully extend the extremity. Recover From Knee Surgery Like a Champion! Arthritis makes it hard for many people to perform their jobs. X-rays showed an area of lucency around an oval bony fragment measuring about 1 cm on the superior aspect of the humeral head. Dr. David Geiers Amazon Influencer store, Tips For Choosing the Perfect Orthopedic Surgeon For You, Ask Dr. Geier: Overuse and Degenerative Knee Injuries. Return to sports can be variable depending on the type of osteochondritis dissecans lesion and the treatment. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Her family history was negative for rheumatologic conditions. MeSH The https:// ensures that you are connecting to the We earn a commission for products purchased through some links in this article. Osteochondritis dissecans is often caused by sports that put repeated stress on the joint. Published by Elsevier Inc. All rights reserved. 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