Osteochondritis dissecans of the elbow

Abstract

Osteochondritis dissecans (OCD) is a disorder of articular cartilage and subchondral bone. In the elbow, OCD is localized mostcommonly at the humeral capitellum. OCD of the elbow can be a signifi cant problem in adolescent athletes, especially in athletesengaged in repetitive overhead activities and gymnasts. The likely cause of OCD of the elbow is multifactorial secondary to repetitivemicrotrauma, biomechanical mismatch, and tenuous vascular supply of the capitellum. Plain radiographs may disclose the lesionbut computed tomography and magnetic resonance imaging are more accurate in the detection of OCD. It is important to diff erentiatebetween stable and unstable OCD lesion to determine the best treatment option. Stable OCD lesions can be initially treatednonoperatively with elbow rest or activity modifi cation. Surgery is indicated for patients who have unstable OCD lesion, those inwhom nonoperative management failed, or those that have loose bodies with associated mechanical symptoms. The potentialsurgical interventions include bone marrow stimulation techniques, internal fi xation of large fragments, and osteochondral autografttransplantation system. The aim of this article is to review current concepts on the aetiology, clinical presentation, diagnosis,treatment, and outcomes of elbow OCD.