Management of Osteochondritis Dissecans Lesions of the Knee, Elbow and Ankle.

Background:Osteochondritis dissecans (OCD) of the elbow has almost exclusively been described in the humeral capitellum, with only a small number of reports describing secondary osteochondral chang...

https://journals.sagepub.com/doi/pdf/10.1177/2325967118769059

Radial Head Changes in Osteochondritis Dissecans of the Humeral Capitellum.

This review presents the current understanding of the etiology, pathogenesis, and how to diagnose and treat osteochondritis dissecans (OCD) at the elbow joint followed by an analysis of particular characteristics and outcomes of the treatment. OCD is seen in patients with open growth plates (juvenile OCD [JOCD] and in adults [AOCD] with closed growth plates [adult OCD). The etiology at smaller joints remains as unclear as for the knee. Mechanical factors (throwing activities [capitulum] seem to play an important role. Clinical symptoms are unspecific. Thus, imaging techniques are most important for the diagnosis. In low-grade and stable lesions, treatment involves rest and different degrees of immobilization until healing. When surgery is necessary, the procedure depends on the OCD stage and on the state of the cartilage. With intact cartilage, retrograde procedures are favorable while with damaged cartilage, several techniques are used. Techniques such as drilling and microfracturing produce a reparative cartilage while other techniques reconstruct the defect with osteochondral grafts or cell-based procedures such as chondrocyte implantation. There is a tendency toward better results when reconstructive procedures for both the bone and cartilage are used. In addition, comorbidities at the joint have to be treated. Severe grades of osteoarthritis are rare.

https://journals.sagepub.com/doi/pdf/10.1177/1947603519847735

Osteochondritis Dissecans of Smaller Joints: The Elbow.

Osteochondritis dissecans of the elbow mainly involves the capitellum; however, no authors have reported the condition in the radial head with subluxation of the radial head We report four cases in which osteochondritis dissecans involved the radial head and was accompanied by radial head subluxation All patients were male and their ages ranged from 11 to 13 years (average, 118 years) All lesions were located at the posteromedial aspect of the radial head with anterior subluxation of the radial head Fragment removal was performed in one case and ulnar osteotomy in two cases; the remaining case was treated conservatively with the prohibition of sports Three cases had a good outcome, whereas obvious anterior subluxation of the radial head and limitation of elbow flexion remained in the case treated with fragment removal

Pathomechanical Significance of Radial Head Subluxation in the Onset of Osteochondritis Dissecans of the Radial Head

Background
Osteochondroma is the most common benign bone tumor of the upper limbs that occurs during the developmental phase of children. Solitary epiphyseal enchondromas can be usually found in the humeral capitellum, and the proximal ulna of the elbow.

/pdf/chronic-radial-head-dislocation-caused-by-a-rare-solitary-2ig9rxpw13.pdf

Chronic radial head dislocation caused by a rare solitary osteochondroma of the proximal radius in a child: a case report and review of the literature

Osteochondritis dissecans of the radial head: A case report

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Osteochondritis dissecans of the radial head: A case report