Osteochondritis dissecans

What is it?

Osteochondritis dissecans involves loss of blood (and death) of part of the cartilage at the elbow. The exact cause is unknown and may relate to repetitive trauma or genetic característics which make these individuals more likely to develop this condition.

It occurs most often in young people between the ages of 10 and 18 and can be associated with sports that overload the elbow (eg baseball, tennis, gymnastics).

In cases where cartilage only exhibits partial rupture or remains in place, spontaneous self-resolution may occur. In complete lesions in which the fragment moves, surgery may be indicated.


What are the symptoms?

Patients may complain of pain, particularly extreme flexion or extension, blocking or cracking sensation, swelling of the elbow, or difficulty in mobilities, which may be impaired.


How is the diagnosis made?

Diagnosis is based on clinical examination and imaging. Elbow radiography may reveal changes but magnetic resonance imaging is usually critical for establishing the definitive diagnosis and assessing the extent of the lesion.


What are the therapeutic options?

Treatment consists of rest, physiotherapy or orthoses, in addition to analgesic medication.

Surgery may be indicated and, depending on the location and size of cartilage involved, the fragment may be removed from the elbow, reinserted with stitches or screws in its original location, or treated with bone fragments to stimulate the growth of new cartilage.

These surgeries can usually be performed arthroscopically, minimally invasively, through small incisions. Antebrachial suspension is used for a few weeks after surgery to provide comfort and support, as well as to allow healing/recovery. In some cases, physiotherapy is required.