Osteochondritis Dissecans (OCD) of the Elbow
What is OCD of the Elbow?
Osteochondritis Dissecans is a condition in which fragments of bone and cartilage become separated from the joint surface and form loose bodies in the joint. These fragments usually originate from the humeral side of the joint.
What causes OCD?
It is currently thought that most OCD lesions occur as a result of a traumatic injury that occurred in the patient's past. They can also occur in throwing athlete as a result of overuse. Some lesions do not have an identifiable cause.
What are the symptoms?
Patients will complain of clicking and locking in the elbow. Patients complain of pain, and are often unable to fully extend their elbow.
How is an OCD lesion diagnosed?
Physical exam reveals loss of motion or clicking in the elbow. The area the bone chips came from may be tender to the touch. X-rays will confirm the diagnosis. An MRI may be obtained to help determine stability of the fragment. Fluid seen behind the fragment on MRI is an indicator of instability, and an indication for surgery.
How is it treated?
Stable lesions, those not likely to displace, are treated with rest, anti-inflammatory medications and observation.
Unstable lesions, or those that have become loose bodies, are removed arthroscopically. Depending on the patient's age and activity level, a microfracture may be performed at the time of arthroscopy. A microfracture is a procedure used to repair damaged cartilage. The surgeon drills into the bone where the lesion is located. The drill hole allows bone marrow to leak into the lesion bringing with it blood cells that are capable of forming new cartilage.