Capitellar Osteochondritis Dissecans (OCD)

Well with my surgery I had that screw that was exposed and very sensitive even to a flick for over a year... So i sat our football wasn't taking a helmet to the elbow ha. Umm yes I'd start with body weight after rehab. Just Pushups, not too heavy but helps strengthen and not stress the elbow too much. I'd recommend tons of lower body. The term building from the ground up. It all starts from a solid base and core. The rest will come from supporting the weight

Matt,

Did you experience "catching" or "locking" in your elbow prior to surgery?  If yes, how long did it take to go away post-surgery?  My son has a centrally located lesion but the cartilage is perfectly intact.  Recently had arthroscopy and drilling to get blood flow back to dead bone. 

Yes I could really feel it after throwing a football in the fall before I had surgery in December. I could felt it lock or just nothing behind my ball. They think I pitched on it for some time.. I had a long run with those Williamsport teams and stuff, I was maybe throwing 70mph going into hs. Then low 80s post surgery the summer between my freshman and sophomore year when I was cleared to pitch. But velocity is over rated. Its all location. The change up no breaking balls

Yes it did. But of course after being in a cast and rehabbing it was pretty stiff to start. But I mean I've thrown a lot of innings after. And Yes after 9 years at 23. I developed minor arthritis. Which is going to happen with my elbow being hinged by a screw and over 100,000's of throws. But I'd take Celebrex during pro ball. But its really not a major problem at all. The strength is there. Say if I were doing DB bench. my right arm is stronger and bigger than my left. But my left is more stable and locks out first. So its all about stability. For me it was cold whether and having metal id need a few throws close to get the elbow going and after that its good to go.

My son is 14 years old, and is a pitcher. He has played baseball since 4 years old. He plays other positions, as well as pitcher. He was diaginosed with Capitellar OCD w/ small joint effusion (Localized fragmentation of the bone, no definite loose body identified) ~ my son cannot straighten his elbow at all, and has chronic pain. His 1st xray was about a month ago (along w/ MRI) He has not thrown, swung a bat, NOTHING involving the elbow in about a month. Because his pain is getting worse, I returned to Dr. and they took another x ray, and there was no change, no improvement. One dr. says surgery, another says rest for 3 months.....just want anyones opinion on this. He has had tendonitis of the same elbow for 2 years prior.

Hi - baseballsurfmom, If your son is anxious to get back to playing my advice would be to have the surgery now if you have a good doctor with OCD experience who wants to do it now. My son finally had his surgery on October 15th, prior to that he had rested it for 4 months and x-rays did show improvement but as soon as he started light throwing again he ended up with loose bodies and could not straighten his arm all the way.  The first step is always rest but it seems like most of the kids end up needing surgery anyways. After the rest and then the recovery from surgery it will put my son at 1 year without any baseball and he will probably not be doing any pitching for an additional 3 or 4 months after that.

My son goes back to his ortho today at 4:20 - almost 5 months post surgery.  Everything has gone very well,  We are hopeful that we will start talking about a return to throwing, maybe establish a timetable.  

 

Baseballsurfmom - do you want to have the surgery done now or in 3 months?  He is going to have the surgery; it is just a question of when it is done.  I'm not a doctor, so my opinion is worth everything you paid for it, but I have given you the situation in a nutshell.  I faced the same choice.

Son gets to move on to the next step: the rehab throwing program!  It is the same rehab program that Tommy John recipients do, except he has permission to move through it as quickly as his elbow tolerates without discomfort.  Looking at the x-rays, the hole in the cartilage is almost undetectable now.  

He was released for wall or table pushups at 3 months post surgery with pushups and light weights added at 4 months.  He has played in 2 basketball games with no problems at all.

 

His doc stressed the importance of doing the rotator cuff exercises (Jobe's).  He is almost more concerned about the risk of injury to the shoulder after the long layoff than he is about the elbow.

Well all right!  Just finished another throwing session.  He started at 30 feet, then to 45, 60 now 90.  In addition to warming up, he does 2 sets of 25 at a distance then, after a day or two of rest, 3 sets of 25 at that distance, then moves up.  Under this program, once a player completes 180', he is considered ready to return to position play, and a pitcher can start mound throwing.  

 

He is having no problems at all to this point.  I have to get him to ease up at times; he wants to accelerate the program.  I am more concerned about my arm.  I am the only one with soreness the day after a workout.  I'm not looking forward to those 120' sessions.

 

So my son went for his 4 month post-op appointment yesterday, so far he has been progressing great with full range of motion back and no pain at all.  We had an MRI last week because the Dr. wanted to see how the inside was looking.  The Dr. said everything looks great actually way better than he was expecting for only 4 months post-op, the ocd is all filled in with cartilage, he is cleared to start hitting but it should be a gradual progression starting with just swinging the bat, then tee, soft toss, to full hitting over the next 6 weeks, then he will start a throwing program. He said a little pain that goes away should be expected but any pain that sticks around then we back off and slow down. So really good news, as far as the Dr. is concerned my son is healing ahead of schedule and should have a complete recovery.  How is your son doing southdsidevadad? 

Glad to hear your boy is progressing nicely.  I'm glad your note came up in my e-mail as I have been meaning to post something.  He has completed his throwing program which finished with 3 sets of 25 throws at 180 feet.  Now he has added flat ground bullpen sessions.  We went back to the doctor on Wednesday.  The hole has filled in and everything looks fine.  We do not have to go back to see the doctor unless something starts hurting.  He will be on short starts, of course, and will continue to build his pitching stamina.  We will monitor his elbow carefully, but so far he has had no discomfort at all.  

I had posted on here about 4 months ago about my sons elbow, and after full rst for 4 months his OCD in elbow had not healed at all, but actually got worse even with full rest. He is 15, and had surgery yesterday ~Over 4 hours surgery  ~ The surgery included Right elbow arthroscopy, osteochondial fixation, drilling, open osteochondrial graft from the knee.
2 incisions on elbow, 1 on knee. He is home now, arm has nerve block from anesestia (sp?) which should last throughout the day, so arm is numb. He is in a lot of pain, especially knee area, and elbow is starting to hurt too. Go back to Dr. on Friday. Please let me know if anyone has had this procedure or something similiar, and what to expect for the next few days. Thanks in advance.

I kept an Evernote notebook of medical articles about OCD.  The reviews of the operation your son had (I believe it is called Osteochondral Autograft Transfer or OAT) are very good.  The studies show that he should be able to throw without pain in 6 months, and he should return to playing baseball at the same level after full rehabilitation.  From what I have read, his operation sounds normal.  The OAT procedure involves a little more pain because 2 joints are being operated on.  The hardest part is now over and he can look forward to getting back to normal!

 

Do you know the size of his lesion and whether it extended to the margin of the cartilage? From what I have read, it is performed on larger lesions or ones that are not completely surrounded by cartilage.  As my son's was relatively small, the recommended procedure for him was the debridement and microfracture.

 

I hope that he is feeling better and is now on the road to full recovery.

Yes, it was the OATS procedure. His lesion was approx 1.5 cm X 1.7 cm. There was basically a "pit" in his elbow that was removed. Usually only cartilage is taken out of knee, but because it was so bad, bone had to also be taken. Needless to say, his elbow was a mess! My son had not pitched alot in the last year. (since Middle school anyways) But, he did admit after the surgery that his elbow had been bothering him a few months prior to him telling us. I guess it was like a dull ache, everytime he threw the ball. But just not bothering him enough to say anything. He was playing with a 16 yr old team, and he was only 14, and doing good, and he wanted to play. His passion for baseball is beyond measure, so he just kept going. Unfortunately this is the outcome. Trying to stay positive, and he is determined to come back stronger than before, so that is great! We are getting pics on Friday with exact measurements of lesion, ect. Thanks for the reply! 

Two years after his surgery, my son completed his high school athletic career with no lingering elbow problems.  He finally got into lifting weights and the lifelong contact hitter suddenly discovered that he had power (2 home runs on senior night were special).  He made first team all state for private schools.   Rather than continue his baseball career at a D3 school, he chose a large state university and entered the Air Force ROTC, so I think he has joined a very good team and will do just fine.  

Good wishes to all of you baseball parents.  I hope you all treasure your sons' time in high school baseball; it goes quickly!  

Update on where we are at:

My son Nick had a lesion that was 6 mm x 7mm centrally located with a loose body.  Arthroscopic surgery at the University of Wisconsin to remove the loose fragment, debridement, and microfracture on 8/31.  He was in a sling until 9/9 and then began physical therapy with about 6 weeks of range of motion and 6 weeks of strengthening therapy.  To keep him sane we continued to have him take infield ground balls a month after surgery which kept him optimistic about rehab and helped his range of motion.

He was cleared to take batting practice and begin rehab throwing on 12/1 which is where we are at now.  Throwing rehab program is a gradual build up over 4-6 weeks from 30 feet to 120 feet and then on to UW Sports Medicine's throwing program sometime in January.  He throws and hits with no pain, full range of motion, and all looks good so far. 

Hi all, my 10 year old was diagnosed  with this last week and is scheduled for surgery this week. Wondering his chances of returning  to baseball in any capacity. I would be interested in how some of your sons have progressed. Information seems to be hard to find. I appreciate any feedback. 

KiddDeuce posted:

Hi all, my 10 year old was diagnosed  with this last week and is scheduled for surgery this week. Wondering his chances of returning  to baseball in any capacity. I would be interested in how some of your sons have progressed. Information seems to be hard to find. I appreciate any feedback. 

Just sent you a PM.

My son had an arthroscopic procedure with loose body removal and micro fracture last week. His lesion ended up being about 10mm in diameter. Hoping that recovery goes well and he can return to the sport he loves. Did anyone make use of any collagen (or other) supplements during recovery? I know time and patience are the two biggest things to focus on going forward....

KIDDDEUCE -

I posted about my son previously in this post but haven't given an update in a while and I know how nice it is to hear positive outcome stories when you are going through this.  My son had the same procedure as your son his freshman year of high school, his surgery was in October 2014 so by the time his baseball season came around he was able to bat but did not pitch or play in the field.  His sophmore year he was back to normal and made the varsity team.  He had a good season and had no problems at all although we made sure to stay conservative with the amount of pitching he did.  He also had a very successful summer baseball season, pitching and playing outfield.  This year as a junior he is the #1 pitcher for varsity and so far is 8-0 for the season.  He has had no issues at all with his arm since his surgery and we are grateful.  I do have him take glucosamine chondroitin and vitamin D, I don't know if it helps but I know it doesn't hurt.  Good luck!   

MuskyShane posted:

Update on where we are at:

My son Nick had a lesion that was 6 mm x 7mm centrally located with a loose body.  Arthroscopic surgery at the University of Wisconsin to remove the loose fragment, debridement, and microfracture on 8/31.  He was in a sling until 9/9 and then began physical therapy with about 6 weeks of range of motion and 6 weeks of strengthening therapy.  To keep him sane we continued to have him take infield ground balls a month after surgery which kept him optimistic about rehab and helped his range of motion.

He was cleared to take batting practice and begin rehab throwing on 12/1 which is where we are at now.  Throwing rehab program is a gradual build up over 4-6 weeks from 30 feet to 120 feet and then on to UW Sports Medicine's throwing program sometime in January.  He throws and hits with no pain, full range of motion, and all looks good so far. 

While I am sorry that you had to experience this injury, I am appreciate that you shared your experience regarding your son.  My son was diagnosed with a 5mm lesion but it is stable.  We just met with the UW doctor and he stated that surgery is not recommended at this time.  While on the surface this is good news, the unfortunate thing is that he has already been resting his arm for the last 18 months.  We have heard that it is 80% healed but he has hit a plateau because he has not seen much improvement for the last 8 months.  As a result, we have no idea if/when this thing will heal.  I am wondering if anyone out there has had such a long recovery (with no surgery) and actually had eventual luck in becoming 100% healed?  Since it has been so long, we are just wondering if this will ever fully heal on its own?

Ballgame 23 ~ 

 

How old is your son? 18 months is a long time to rest with only 80% healing. Depending on his age....I would definitely get a 2nd and even 3rd opinion. My son was diaginosed when he was 14, he rested for about 6 months, only to find out his elbow was getting worse, even with resting it. So they did surgery. There are plenty of success stories where conserative (resting) will heal.....but personally I wish we didn't have to wait the 6 months before doing the surgery. My son missed his whole freshman year of high school recovering and doing physical therapy. He basically was out almost a year and a half with resting , sugery and recovery. I think age plays an important factor. He is fine now....he had bilateral OCD, he has surgery on right elbow, and 4 months later his left elbow had the same...and had to have surgery again. I guess the one bright spot is you say the lesion is stable. I would definitely get a few more opinions. 

I agree 200% with Baseballsurfmom.  That is way too long in my mind to be sitting around with conservative treatment.  Go get a second opinion right away.  I hear of more conservative treatments that drag on until surgery is determined to be the right answer than you would believe.  

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