How is elbow OCD diagnosed?
Dr. Mazzara will conduct a thorough medical history as well as physical examination of the patient’s elbow. He will check for tenderness, range of motion, pain and crepitus when the elbow is bent or straightened. X-rays are needed to confirm the diagnosis and often an MRI will help determine the amount of damage to surrounding soft tissues and bone damage. Lesions or tears found through an MRI are classified as follows:
- Grade 1: Stable – Cartilage is intact but there is thickening and beginning signal changes within the bone. (A signal change means the MRI has found an abnormality.)
- Grade 2: Stable – Cartilage has been damaged and there is a lesion (crack or tear) in the bone.
- Grade 3: Unstable – Cartilage has been damaged and there is a bone fragment with synovial fluid present.
- Grade 4: Unstable – Loose body (such as a piece of bone) within the joint.
How is “Little League Elbow” treated?
Athletes will need to stop their usual sporting activity that led to elbow OCD. Dr. Mazzara may prescribe a non-steroidal anti-inflammatory medicine to help reduce pain and swelling within the joint. Eventually physical therapy may be necessary to help with flexibility and range of motion. Therapists also work with athletes to help them improve their form in ways that reduce strain on the elbow during sports. In severe cases, patients may wear a sling or splint to immobilize the joint and facilitate healing. In younger patients, less than 10 years old, this condition is usually called Panner’s disease and will usually heal over time.
How to treat elbow OCD with surgery
The type and extent of surgical treatment depends on the grade of the lesion. Dr. Mazzara can perform this type of surgery either openly (where he opens the elbow to see the joint clearly) or arthroscopically with small incisions and small surgical instruments. He may perform one or more of the following procedures:
- Debridement: This is common for elbow OCD and involves clearing away the damaged tissue with a small shaving instrument. Often, Dr. Mazzara will use a small instrument to poke holes through the damaged area and into the healthy bone just below. This causes the holes to bleed and promotes healing.
- Pinning: If the section of bone has detached, Dr. Mazzara may pin the bone back in place with bio-absorbable pins.
- Grafting: A small area of damaged bone in the joint may be replaced with a graft. An autograft is tissue from the patient’s own body, taken from a nearby area and placed in the damaged area. Smaller lesions can be grafted with the patient’s own bone and cartilage in an OATS procedure. Larger lesions may require donor grafting procedures.
For more information on osteochondritis dissecans of the elbow, or if your teen is suffering from elbow pain, please contact the orthopedic office of Dr. James Mazzara, elbow specialist, serving patients living in Manchester, South Windsor, Enfield, Glastonbury and surrounding Hartford Connecticut communities.