What is Arthroscopic Treatment of Osteochondritis Dissecans?
Overuse injuries are responsible for many of the nontraumatic elbow injuries seen in young athletes. One of these over-use injuries is called osteochondritis dissecans (OCD) of the elbow or capitellum. The capitellum is a small head or rounded part of the elbow on the inside of the arm, closest to the body. Many of these injuries can be treated with rest and activity modification. However, when non-surgical treatments fail, or if the athlete is experiencing unstable lesions (tears,) loose bodies, or persistent mechanical symptoms, arthroscopic treatment of osteochondritis dissecans may be necessary. Dr. James Mazzara, elbow surgeon serving Manchester, South Windsor, Rocky Hill, Glastonbury and surrounding Hartford communities has extensive experience with arthroscopic treatment of osteochondritis dissecans of the elbow.
What are Arthroscopic Treatment Techniques for OCD Lesions?
Elbow arthroscopy has become the orthopedic gold standard for evaluating and treating symptomatic OCD lesions. Arthroscopic debridement and bone marrow stimulation have shown good results. Here are some of the arthroscopic treatments for osteochondritis dissecans of the elbow:
- Microfracture and Debridement: This common arthroscopic treatment of osteochondritis dissecans of the elbow involves clearing away the damaged tissue with a small surgical shaver. During debridement, Dr. Mazzara will use a small shaving instrument to smooth out the sharp bone fragments. A small instrument is used in the microfracture technique to poke holes through the damage area and into the healthy bone. The holes and shaving will cause the bone to bleed, which promotes healing inside the arm. This also allows the release of mesenchymal stem cells (MSCs) that can create scar cartilage.
- Fixation: If the section of bone has detached, Dr. Mazzara may pin the bone back in place. The size of detached bone determines the types of pins, wires or screws to be used. In some cases, Dr. Mazzara will use bioresorbable screws which are made from poly L-lactic acid (PLLA) and are absorbed by the body.
- Grafting: A small area of damaged bone in the joint may be replaced with a graft. A bone graft helps to fill the gap after removal of the dead or necrotic bone. An autograft is tissue from the patient’s own body, taken from a nearby area and placed in the damaged area, and allograft is taken from a donated bone, or cadaver.
Are you a candidate for arthroscopic treatment of osteochondritis dissecans of the elbow?
There are two ways to initiate a consultation with Dr. Mazzara:
You can provide current X-rays and/or MRIs for a clinical case review with Dr. Mazzara.
You can schedule an office consultation with Dr. Mazzara.
What is the recovery time after elbow OCD surgery?
The recovery after arthroscopic treatment is usually faster than after open surgery. Dr. Mazzara suggests beginning active-assisted motion exercises within a few days after surgery to aid in the return of range of motion. Strength exercises are usually started 8 weeks after arthroscopic treatment if the patient has no pain and a normal range of motion. Shortly thereafter a throwing program can begin to return the patient to their sports activities.
For more information about arthroscopic treatment of osteochondritis dissecans of the elbow please contact the office of Dr. James Mazzara, elbow surgeon treating patients living in Manchester, South Windsor, Rocky Hill, Glastonbury and surrounding Hartford communities.