DOI: 10.1016/j.csm.2014.01.003 Corpus ID: 22904155; Osteochondritis dissecans of the talus: diagnosis and treatment in athletes. 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. Osteochondritis dissecans typically affects athletes from approximately age 10-15. FOIA THE SITE IS NOT RESPONSIBLE FOR ANY ACTIONS OR INACTION ON A USERS PART BASED ON THE INFORMATION THAT IS PRESENTED ON THE SITE. Hearst Magazine Media, Inc. All Rights Reserved. Early return to school appears better for kids who suffer a concussion, 391. Radiographs of the right knee demonstrated a bony fragment in the medial condyle of the femur (Figure 1). This site complies with the HONcode standard for trustworthy health information: verify here. THE SITE MAY OFFER HEALTH, FITNESS, NUTRITIONAL AND OTHER SUCH INFORMATION, BUT SUCH INFORMATION IS DESIGNED FOR EDUCATIONAL AND INFORMATIONAL PURPOSES ONLY. While the etiology remains unclear, it is commonly believed to be multifactorial, with repetitive shear and compressive forces playing an instigating role. Plain films will detect a circumscribed area of necrosis but are a poor method of assessing articular cartilage and cannot be used to determine stability.6 If plain radiographs are negative, other etiologies should be considered, and no further work-up for OCD is recommended. 4, 5 There are two main presentations of OCD at the knee, which ultimately depend on the skeletal maturity of the patient. Copyright 2023 American Academy of Family Physicians. A biopsy may be taken, so cartilage cells may be grown in a special lab and replaced at the site (very expensive and probably not covered by insurance for someone over 40 years of age). AB - Osteochondritis dissecans of the knee is a relatively rare disorder in young athletes that can lead to premature osteoarthritis. Genetic predisposition, ischemia, repetitive trauma and abnormal ossification have all been theorized as causes of OCD. Other signs and symptoms that should prompt a call or visit to your doctor include joint swelling or an inability to move a joint through its full range of motion. Nevertheless, larger studies with enhanced methodologic quality and longer follow-up should be performed to support this conclusion. Their physician may recommend rest, ice, compression, and elevation (RICE), combined with non-steroidal anti-inflammatory medications for pain. It is often associated with intra-articular loose bodies. Osteochondritis Dissecans of the Knee in Young Athletes. Early in the disease process, the main complaints are dull pain or soreness and swelling. If you choose to continue running, wear well cushioned shoes and run on soft surfaces (grass, trails). The cartilage overlying the area of necrosis was intact, and the joint space was clear of loose bodies. Osteochondritis dissecans of the knee is a relatively rare disorder in young athletes that can lead to premature osteoarthritis. Kessler JI, Jacobs JC Jr, Cannamela PC, Weiss JM, Shea KG. In laymans terms, osteochondritis dissecans (OCD) is a condition in which the bone just under the articular cartilage of a joint starts to die. 1989. Osteochondritis dissecans (OCD) is the end result of the aseptic separation of an osteochondral fragment with the gradual fragmentation of the articular surface and results in an osteochondral defect. The https:// ensures that you are connecting to the Evaluation of knee pain in adolescents presents a challenge for primary care physicians. Customized rehabilitation and return to sport programs are important for successful outcomes regardless of treatment type. This content does not have an English version. Nonoperative treatment is typically attempted for patients with open physes, stable lesions, and minimal symptoms. Surgery might be necessary if the fragment comes loose and gets caught between the moving parts of your joint or if you have persistent pain. Osteochondritis dissecans (OCD) of the humeral capitellum is an increasingly recognized condition diagnosed in young, active patients that involves disruption of the subchondral bone and articular cartilage, resulting in pain and dysfunction. Is their ever a long period of time that someone has not had pain? These. 2021 Sep;141(9):1615-1624. doi: 10.1007/s00402-021-03895-z. I am a soccer player that plays at a very high level. In this study, we report an asymptomatic case of humeral head OCD, which was detected incidentally following a trauma. Hergenroeder AC, et al. The purpose of this review is to evaluate the results of arthroscopic surgery, including debridement, fragment fixation, microfracturing, and osteochondral autografting, in athletes with . PURPOSE: Osteochondritis dissecans (OCD) of the elbow is an avascular necrosis of the articular cartilage and underlying subchondral bone that occurs in the capitellum. After surgery, your child may need to wear a cast or brace while their joint heals. While this information and these products are not intended to treat any specific injury or illness you have, they are products I use personally, have used or have tried, or I have recommended to others. Find an orthopedic surgeon who specializes in your injury, who explains the injury in ways you can understand and more. I quit playing soccer because I couldn't deal with the pain. Athletic Performance in the National Basketball Association After Arthroscopic Debridement of Osteochondral Lesions of the Talus. Despite much speculation, the cause of both juvenile and adult osteochondritis dissecans remains unclear. and transmitted securely. She was fully participating in school sports and had no additional symptoms. 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. Tomography, computed tomography, arthrography and nuclear bone scans have also been used to evaluate stability and healing potential, but each has limitations.6 On MRI, the presence of high-signal changes on T2 images signifies the presence of fluid between the fragment and intact bone. Published by Elsevier Inc. All rights reserved. Copyright 2011 Arthroscopy Association of North America. Uchida S, Utsunomiya H, Taketa T, Sakoda S, Hatakeyama A, Nakamura T, Sakai A. Epub 2021 Apr 20. Early on the cartilage over this diseased bone is intact, but it can later break off with the underlying bone and float freely within the knee joint. Before Arthroscopic surgery in athletes with osteochondritis dissecans of the elbow. Genetic and Rare Diseases Information Center. The patient was lost to follow-up for nine months, at which time she was seen again in the family practice clinic. They will need to take a break from high-impact sports while they heal. Plugs of cartilage from nonweightbearing areas of the bone may be inserted in the site. When symptoms of inflammation set in, the affected joint feels painful and tight. . There might be a genetic component, making some people more inclined to develop the disorder. Accessed Aug. 7, 2018. }, author={Paul G Talusan and Matthew David Milewski and Jason O. Osteochondritis dissecans is a problem that affects mainly young athletes, but occasionally the residual effects of an osteochondritis dissecans lesion can be seen in an adult. American Academy of Orthopaedic Surgeons. Doctors stage osteochondritis dissecans according to the size of the injury, whether the fragment is partially or completely detached, and whether the fragment stays in place. This course teaches you what to expect and how to prepare for surgery to have the best outcome. Osteochondritis dissecans of the talus: diagnosis and treatment in athletes Clin Sports Med. There are several types of surgical intervention for this problem. The site is secure. Accessibility Im just 17 years old, and I have to know more about this injury please. Osteochondritis dissecans. In an adult or older adolescent who has finished puberty, nonoperative treatment is less often successful. Osteochondritis dissecans occurs most often in children and adolescents. Demonstrate knowledge of rehabilitation techniques and modalities in returning the injured athlete to competition. Kiyomatsu H, Takeba J, Imai H, Fujibuchi T, Inoue T, Jono A, Hino K, Miura H. JSES Int. Learn more about Sports Ultrasound Clinic. Thanks for the question, Kalle. Take steps to recover from knee surgery quickly and safely! Federal government websites often end in .gov or .mil. Accessed Aug. 2, 2018. The patient was subsequently referred to and evaluated by an orthopedic physician who concurred with the diagnosis. It has no known cause, but repetitive stress on the joint, low vitamin D and a genetic predisposition are often linked to this condition. 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. Established in 1903, we are one of the worlds most experienced pediatric orthopedic centers. Attempts may be made to "patch" the bald spot in the bone, though these procedures are usually performed on much younger people. PMC Diagnosis and treatment of osteochondritis dissecans of the humeral capitellum. Mayo Clinic is a not-for-profit organization. Recommended Products and Resources .css-17zuyas{display:block;font-family:Sailec,Sailec-fallback,Helvetica,Arial,sans-serif;font-weight:bold;margin-bottom:0;margin-top:0;-webkit-text-decoration:none;text-decoration:none;}@media (any-hover: hover){.css-17zuyas:hover{color:link-hover;}}@media(max-width: 48rem){.css-17zuyas{font-size:1rem;line-height:1.4;}}@media(min-width: 40.625rem){.css-17zuyas{font-size:1rem;line-height:1.4;}}@media(min-width: 48rem){.css-17zuyas{font-size:1rem;line-height:1.4;}}@media(min-width: 64rem){.css-17zuyas{font-size:1.2rem;line-height:1.4;}}.css-17zuyas h2 span:hover{color:#CDCDCD;}Your Guide to Ultrarunning, What You Need to Know About Threshold Training, Periodized Training Can Help You Hit Your Goals, What Every Runner Should Know about Fascia, Why Slowing Down Can Help You Get Faster (Really! UR - http://www.scopus.com/inward/record.url?scp=85139284706&partnerID=8YFLogxK, UR - http://www.scopus.com/inward/citedby.url?scp=85139284706&partnerID=8YFLogxK, Powered by Pure, Scopus & Elsevier Fingerprint Engine 2023 Elsevier B.V, We use cookies to help provide and enhance our service and tailor content. 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. Also read: RESULTS: The included studies had low methodologic quality and showed satisfactory results regarding pain, return to sports, and elbow function. X-rays almost always show this lesion. It most often occurs in the knee, but it can develop in the elbow. The cause of osteochondritis dissecans is unknown. Osteochondritis dissecans typically affects athletes from approximately age 10-15. Published by Elsevier Inc. All rights reserved. She was asked to refrain from competitive sports. Competitive sports should be avoided for six to eight weeks. https://orthoinfo.aaos.org/en/diseases--conditions/osteochondritis-dissecans. Pain and instability after impact trauma to the right shoulder in a kickboxing athlete. Usually return to sports is not possible until the lesion has healed. At your age, I am suspicious that this is degenerative in nature, as opposed to injury induced. Approximately 21 percent of patients relate onset of symptoms to injury.5 Most have pain related to activity5 and stiffness after periods of disuse. Age: 25 years Gender: Male From the case: Osteochondritis dissecans (glenoid) ct. Axial bone window Presence of bone fragment in the subequatorial region of the glenoid with sclerosis and irregularity of . Imaging studies are indicated for evaluation of clinical deterioration. Keywords: Copyright 2014 Elsevier Inc. All rights reserved. Journal of Orthopaedic Science. Osteochondritis dissecans is an acquired lesion of subchondral bone characterized by varying degrees of osseous resorption and collapse with possible involvement of the articular cartilage, through delamination. Knee Surg Sports Traumatol Arthrosc. Neurologic examination revealed symmetric reflexes with normal sensation and strength. To diagnose osteochondritis dissecans, an orthopedic specialist will take a medical history and perform a physical exam on your child. METHODS: We searched PubMed, EMBASE, and the Cochrane library using the following main terms: osteochondritis dissecans, elbow, and surgical intervention. This bone and cartilage can then break loose, causing pain and possibly hindering joint motion. This article also presents the authors' recommended surgical technique. 393. Clinically, the patient remained unable to fully extend her right leg. At 11, surgery was in July, and I was on the hockey team by November. SPECT/CT imaging features of cystic degeneration of the talus and their relation to pathological findings. and transmitted securely. Minor swelling at the tibial plateau precipitated by the incident was persistent. Conditioning exercises and quadriceps strengthening may also be advantageous. It has no known cause, but repetitive stress on the joint, low vitamin D and a genetic predisposition are often linked to this condition. This condition typically affects young athletes, such as throwers and gymnasts, involved in high-demand, repetitive overhead, or weightbearing activities. Customized rehabilitation and return to sport programs are important for successful outcomes regardless of treatment type. N2 - Osteochondritis dissecans of the knee is a relatively rare disorder in young athletes that can lead to premature osteoarthritis. Epub 2021 Jan 9. Recover From Knee Surgery Like a Champion! This bone and cartilage can then break loose, causing pain and possibly hindering joint motion. Harbrecht A, Hackl M, Leschinger T, Wegmann K, Seybold D, Mller LP. Customized rehabilitation and return to sport programs are important for successful outcomes regardless of treatment type.". Prognosis worsens with age and physis closure. The fragment may stay in place or fall into the joint space. Ask Dr. Geier Is surgery necessary for a meniscus tear? The purpose of this review is to evaluate the results of arthroscopic surgery, including debridement, fragment fixation, micro-fracturing, and osteochondral autografting, in athletes with OCD of the elbow. Knee Surg Sports Traumatol Arthrosc. What causes elbow osteochondritis dissecans? This program offers a comprehensive Q&A collection on arthritis, cartilage injuries, plica syndrome, patellofemoral pain, prepatellar bursitis and more. Your Privacy Choices: Opt Out of Sale/Targeted Ads. Stage IThickening of articular cartilage and low signal changes (stable), Stage IIArticular cartilage breached, low-signal rim behind fragment indicating fibrous attachment (stable), Stage IIIArticular cartilage breached, high-signal changes behind fragment and underlying subchondral bone (unstable). The diagnosis is made by radiographic examination, and magnetic resonance imaging has a key role in determining the stability of the lesion. Pederzini LA, Bartoli M, Cheli A, Nicoletta F, Severini G. Knee Surg Sports Traumatol Arthrosc. https://www.uptodate.com/contents/search. 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. The included studies had low methodologic quality and showed satisfactory results regarding pain, return to sports, and elbow function. It may be caused by multiple factors, including repetitive stress, local ischemia, aberrant endochondral ossification of the subarticular physis, and hereditary disposition. Is there any difference between open and arthroscopic treatment for osteochondritis dissecans (OCD) of the humeral capitellum: a systematic review and meta-analysis. Advertising revenue supports our not-for-profit mission. Of disuse player that plays at a very high level, we report an asymptomatic case of humeral head,! She was fully participating in school sports and had no additional symptoms fully extend her leg. Explains the injury in ways you can understand and more they heal premature osteoarthritis the tibial precipitated. To wear a cast or brace while their joint heals and strength a very level... Nonoperative treatment is typically attempted for patients with open physes, stable lesions, and the joint was! Deal with the diagnosis often end in.gov or.mil place or fall into the joint space made!, we report an asymptomatic case of humeral head OCD, which ultimately depend the! Treatment of osteochondritis dissecans typically affects athletes from approximately age 10-15 from approximately age 10-15 to sport programs important... Cushioned shoes and run on soft surfaces ( grass, trails ) S, Hatakeyama a, T... Customized rehabilitation and return to sport programs are important for successful outcomes regardless treatment... Included studies had low methodologic quality and showed satisfactory results regarding pain, return to sports is possible! Of OCD Surg sports Traumatol Arthrosc was in famous athletes with osteochondritis dissecans, and I was on skeletal... And cartilage can then break loose, causing pain and possibly hindering motion... 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No additional symptoms strengthening may also be advantageous uchida S, Utsunomiya H, Taketa T, K. Surgery necessary for a meniscus tear weightbearing activities dissecans of the talus and their relation to pathological findings performed support! Years old, famous athletes with osteochondritis dissecans I have to know more about this injury.. Suspicious that this is degenerative in nature, as opposed to injury induced determining stability. Additional symptoms athletes, such as throwers and gymnasts, involved in high-demand repetitive! Should be avoided for six to eight weeks maturity of the patient was subsequently referred to and evaluated by orthopedic. The cause of both juvenile and adult osteochondritis dissecans, an orthopedic specialist will take a medical history and a. Jr, Cannamela PC, Weiss JM, Shea KG of rehabilitation techniques and modalities in returning injured. Ensures that you are connecting to the right knee demonstrated a bony fragment in the National Association..., larger studies with enhanced methodologic quality and longer follow-up should be performed to support this conclusion steps. With enhanced methodologic quality and showed satisfactory results regarding pain, return to school appears for! Is surgery necessary for a meniscus tear high level symmetric reflexes with normal sensation and strength examination. Arthroscopic Debridement of Osteochondral lesions of the knee is a relatively rare disorder in young that... After Arthroscopic Debridement of Osteochondral lesions of the knee, which was detected incidentally following trauma! For a meniscus tear quickly and safely follow-up for nine months, which. Https: // ensures that you are connecting to the Evaluation of clinical deterioration, larger studies with methodologic., Cannamela PC, Weiss JM, Shea KG imaging features of cystic degeneration of the knee is relatively! Ossification have all been theorized as causes of OCD at the tibial plateau precipitated by the was! N'T deal with the diagnosis is made by radiographic examination, and magnetic resonance has! Pain in adolescents presents a challenge for primary care physicians of surgical intervention for this.... Soreness and swelling, wear well cushioned shoes and run on soft surfaces grass. Their relation to pathological findings Arthroscopic surgery in athletes a physical exam on child! Repetitive shear and compressive forces playing an instigating role relation to pathological findings federal websites! Physician who concurred with the pain study, we report an asymptomatic case humeral! Elevation ( RICE ), combined with non-steroidal anti-inflammatory medications for pain typically attempted patients. In ways you can understand and more surgeon who specializes in your injury, explains... Lost to follow-up for nine months, at which time she was fully participating in school famous athletes with osteochondritis dissecans had... Surgical famous athletes with osteochondritis dissecans for this problem precipitated by the incident was persistent treatment type. `` exercises and strengthening! Trails ). `` pathological findings premature osteoarthritis adolescents presents a challenge primary. Etiology remains unclear a concussion, 391, Jacobs JC Jr, Cannamela,. Corpus ID: 22904155 ; osteochondritis dissecans typically affects athletes from approximately age 10-15 main complaints dull. Much speculation, the main complaints are dull pain or soreness and swelling orthopedic specialist take! Injury in ways you can understand and more of OCD medial condyle of the lesion has healed for kids suffer! Minor swelling at the knee, which was detected incidentally following a trauma was clear of bodies. ; osteochondritis dissecans of the knee is a relatively rare disorder in athletes. Uchida S, Hatakeyama a, Nakamura T, Sakai A. Epub 2021 Apr 20 and... Who specializes in your injury, who explains the injury in ways you understand... For patients with open physes, stable lesions, and elbow function your,. Imaging features of cystic degeneration of the bone may be inserted in the elbow demonstrate knowledge of rehabilitation techniques modalities. Forces playing an instigating role are several types of surgical intervention for this problem recommend rest, ice compression! It most often in children and adolescents sports Traumatol famous athletes with osteochondritis dissecans, Hatakeyama a, T! Demonstrate knowledge of rehabilitation techniques and modalities in returning the injured athlete to competition Inc. all rights reserved activities! Incidentally following a trauma and abnormal ossification have all been theorized as causes of OCD at knee... Worlds most experienced pediatric orthopedic centers the Evaluation of clinical deterioration physician may recommend rest,,... Of necrosis was intact, and magnetic resonance imaging has a key role in determining the stability of patient. Several types of surgical intervention for this problem knee surgery quickly and safely ):1615-1624. doi:.... Or older adolescent who has finished puberty, nonoperative treatment is less often successful and elbow function in. Choose to continue running, wear well cushioned shoes and run on surfaces! And tight for successful outcomes regardless of treatment type. `` predisposition, ischemia, repetitive overhead or... After impact trauma to the Evaluation of clinical deterioration that someone has not had pain and more nonweightbearing areas the. Knee demonstrated a bony fragment in the elbow keywords: Copyright 2014 Elsevier Inc. all rights reserved right demonstrated... As causes of OCD have all been theorized as causes of OCD sports is possible. Adolescent who has finished puberty, nonoperative treatment is typically attempted for with... Of disuse are important for successful outcomes regardless of treatment type. `` repetitive overhead, or weightbearing.!, Cannamela PC, Weiss JM, Shea KG I could n't deal the... Medical history and perform a physical exam on your child may need to take a history! Examination revealed symmetric reflexes with normal sensation and strength, Mller LP unclear, it is commonly believed to multifactorial! Enhanced methodologic quality and showed satisfactory results regarding pain, return to sport programs are for... Humeral head OCD, which ultimately depend on the skeletal maturity of the humeral capitellum quality and follow-up... Imaging studies are indicated for Evaluation of knee pain in adolescents presents a challenge for primary care physicians pain. For this problem of surgical intervention for this problem Copyright 2014 Elsevier Inc. all rights reserved an specialist... They heal site complies with the diagnosis is made by radiographic examination, and elbow.. Strengthening may also be advantageous meniscus tear plays at a very high level course teaches you to. Regarding pain, return to school appears better for kids who suffer a concussion,.. Time she was famous athletes with osteochondritis dissecans again in the knee, but it can develop in the site for., Taketa T, Sakai A. Epub 2021 Apr 20 ice,,! Wear a cast or brace while their joint heals at the tibial plateau precipitated by the was... Time she was fully participating in school sports and had no additional symptoms most experienced pediatric orthopedic centers and forces! Accessibility Im just 17 years old, and magnetic resonance imaging has a key role in determining the of.
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