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I wanted to see if there were any posters familiar with the elbow condition called Capitellar Osteochondritis Dissecans (OCD). I have friends that are in the process of getting opinions from several orthopedic doctors who specialize in elbows on what course of action to take to treat their 15 yr old son's condition. They are getting treatment recommendations from doctors but they would like to hear if there are any posters that are have had experience with this condition.

Thanks for your help.
------------------------------------------------------------ "Your talent is God's gift to you. What you do with it is your gift back to God." Leo Buscaglia
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Our son was diagnosed with OCD 6 years ago as a 13 year old. Advice would be to find Orthopedic specializing in baseball injuries and elbows. OCD has had many studies in the last 7-8 years this condition used to be career ending and some orthopedics will still recommend this path. Find Doc who knows sons goals in baseball if son wants to play and get his recommendation. Our son has had 2 surgeries as 14 yr old and 16 yr old but has continued to play and arm now feels better than it has since he was 12 years old.As a parent we knew nothing of this disease and would probably do things different if we had the chance. The Arm should be your Main concern not how quick you get back from injury to the field as OCD is a very serious condition for an athlete.Don't be afraid to ask if the doctor has had much experience with OCD there are some in the South specializing in this particular problem.
My 15yr son was just told that he had OCD. About a year ago he was told that it was a facture of the growth plate. He did not throw for two months and went to therapy but lost a good amount of range of motion.
Next month he is scheduled to see sports orthopedic. He continues to play but does not pitch anymore but still catches, he never has pain or swelling but the lack of range of motion is affecting him now mentally.

One doctor said that surgery would be needed but that there is a chance that the range of motion could get worse.

Are there other options on how to treat this?
Two doctors want to clean up the joint to release the elbow. The fracture is healed but the x-ray shows a separation of the cartilage which might be keeping him from fully straightening his arm. Surgery is a scary option due to fact that it could get worse then better. He has no pain when throwing so it is a hard decision.
Wow - that is a tough decision. The sports ortho should have the best information for you. When 2B was first diagnosed, the doc (team doctor for UF baseball) said that a loss of some range of motion was fairly common among baseball players - injury or not. I will be interested to know what your guy says.

Before 2B had his MRI, the doc told us that microfracture surgery had proven to be very successful at treating OCD, and that it would be our best option if surgery was necessary. It's supposed to get new cartilage to grow, and I did read one study where athletes (gymnasts) were back in serious competition in 5 months. The problem is that the new cartilage may not be as strong as the old cartilage. We were lucky, though. The MRI looked good, no unstable fragments, so no surgery. A month later, the follow up X-ray looked good and the lesion was < 1 cm. He has no pain, range of motion is now even better than his left arm (ice and Alieve every day seems to have really helped), and he is back out on the field - he's a MIF, not a pitcher. We have another X-ray in 2 months. He won't start lifting weights again until it's completely clean, but he is OK to play.

Please let us know how it goes next month. Tell your son to hang in there!
He will be seeing the Dr on Feb 5th I will let you know what he said. My son had a 5cm separation. We went to a physical therapist about year ago and he said the same thing that a lot of major league pitchers have loss range of motion but that a then fourteen year old should not have it at his age.

I am starting to lean on not having surgery because he no longer pitches and catching at his school seems to be log jammed with juniors and seniors. He only catches on his travel team one game per weekend but on the high school team they have him in the outfield so that works to his advantage plus he can really hit so he can DH. Sad thing is most colleges do not recruit DH's.

The sad part is that he will always wonder “what if this would have never happened” as will I always wonder.

Good luck to your to son.

951dad
quote:
Originally posted by Dl5:
I am fourteen years old and have OCD the lesion is border line severe. Seeing a really good Sports otrthopedic surgeon, he reccomends microfracture surgery, and says there is a 50 50 chance things will get better. With a 6+ month recovery no baseball. I would really appriciate any advice. Thanks you

You have a very simple answer ot this quesion at your age. How important is baseball to you? Let me point out, at 14, it may be your World. At 17, when you can drive, date and be social, it may be a PITA.

This is why we did not choose surgery for our son. at 18, still very talented and completely rehabbed, he thanked us. As he drove off with his GF and his free time.
Hi DI5. I am sorry to hear about your OCD! Is it in your elbow? The docs know best, of course, but since you might be in a period of rapid growth like 2B was/is, you might have a better chance of recovery without surgery if you just take some time off (as hard as that seems!). It's a question to ask your doc, anyway.

Since my January post above, we had a follow-up x-ray in April that showed new bone growth, so it's healing great, even while playing the whole season at 2B and leading the team in innings played. The doc expects it to heal completely by August, and 2B hopes to become MIF/P again. Smile
Here is an update on my friend's son who had OCD.

He had surgery in January to clean it up...I don't know all the particulars but the surgery went well and he now back to hitting, he still is not cleared to throw but so far so good...the doctor told them not to come back for follow-up unless he was experiencing pain. So far it has been a positive result.
After viewing all options and getting a second opinion from a docter who believed in not using surgery to heal the body. I decided to have a microfracture on the OCD. They removed the dead bone cleanded it out then did microfracture to stimulate bone and cartilage growth. It all grows back in six weeks but the cartilage takes up to 2 years to grow back. I had the surgery May 28th, and have been rehabbing through physical therapy i was in a sling for 6 weeks and got out nearly a week ago. I have nearly gained full range of motion and I am actively moving my elbow i start strengthening inless than twwo weeks and could be playing as soon as Sept. 2nd, but might skip fall ball just to stay on the safe side. But should make a full recovery by early november. and be able to try and play for my highschool.
"Normal."

That's what the doc said of the X-ray today. We went back for a re-check, and you can't even tell there was ever a problem. Doc said it was a "miracle" but I think it's just the growing human body doing what it does.

I guess if there is a "miracle" it is this: the first doc, back in December 07, said 3 months off, maybe surgery, and they couldn't even get him in for the MRI until after tryouts. We were devastated, until 2B dad said, "why don't you get a second opinion?"

The second opinion doc got him in for the MRI two days later, and said, no pitching, but go play 2B and have fun. So he led his HS varsity team in innings played, had a great season, and then played a rigorous summer schedule that included three week-long tournaments in which he played almost every inning of every game. Second base only, with one game in RF. Ice and Alieve every day. And now he is pain-free with no restrictions whatsoever and looking forward to the fall.

So the moral here is get a second opinion! It may not work out as well as it did for us, but it surely can't hurt. And the other part, more important, don't ignore the pain. Go see a doc and catch it early.
Last edited by 2Bmom

My son was recently diagnosed with osteochondritis dissecans (OCD), so I will post his experiences and what we learn for the benefit of those who are looking for information.  I am keeping an Evernote notebook of everything I read on the subject, and I would be happy to make it available.  Here is an excellent review of the studies on treatment of OCD:  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3435938/

 

Son is a 2016, 16 years old, 6'1" right handed pitcher and still growing (if he wasn't we probably wouldn't be having this conversation).  This injury is not due to over use.  Due to a "trigger point" or muscle spasm in his back in the early part of the season, he only pitched 18 innings (3 games) in the high school season.  We have followed the ASMI/Dr. James Andrews recommendations for pitchers.  He doesn't touch a baseball during basketball season.  OCD is a repetitive use injury, but not necessarily due to over use.  Some athletes just have a predisposition for it.

 

After the season, he experienced significant pain in the elbow and didn't have full range of motion.  He also described a "hit the funny bone" or electric shock feeling going down his forearm at times.  The range of motion was slightly limited, but there was no locking of the joint or grinding sensation.  We treated with ice, rest and anti-inflammatories; it seemed to improve.  I figured he had tendinitis and had him checked out by our GP.  He was concerned and sent us to a hand/elbow specialist with special interest in sports injuries.

 

After an x-ray and going over son's history, the dr. quickly diagnosed OCD and ordered an MRI.  Yesterday, we had the meeting to review the MRI.  It revealed a small, centrally located lesion.  There are no loose bodies floating around.  So, he has OCD but it is not severe and there are no complicating factors.  After discussing the treatment options, we will proceed with the arthroscopic surgery: debridement(getting rid of the damaged tissue) with microfracture to promote growth of blood vessels and replacement of the cartilage.  It is an outpatient procedure. The tissue that replaces the hyaline cartilage is fibrocartilage which is not as good, but should function fine in a very small spot.

 

A conservative approach has him returning to pitching around Jan. 1.  Other sports activity might begin in 3.  We shall see.  The next step is to schedule the surgery.

 

 

 

Son had OCD and underwent microfracture surgery 3 years ago with great results.  He did physical therapy and sat out from baseball for 6 months.  After that, the surgeon cleared him to return to baseball with no restrictions.  His coach was cautious with him and had him play at 1B for one season to limit the amount of throwing.  Then he resumed pitching and catching and has had no problems. 

Thank you for the good wishes.  I have the same questions that you asked, but no answers yet.  I have read that the general timeline for a return to pitching after OCD debridement is 6-9 months.  In approximately a week at the follow-up, he will have an x-ray which will establish the starting point of his healing, and periodic x-rays will monitor the progress. The PT will commence after the follow-up.  It would be nice if he could play basketball this winter and start throwing in January.  

Would love to hear updates - my son (14 - right-handed pitcher)was diagnosed with elbow OCD in early May 2014, and his doctor shut him down for 4 months rest only to have a loose body show up on his most recent x-ray. He is scheduled for surgery on Oct. 15th to remove the loose body and probable micro-fracture based on what the doctor sees once he gets in there. Would love to hear updates on progress and success stories.

The hole where the dead cartilage was removed has filled in with fibrocartilage (not as good as the original hyaline cartilage, but supposed to be functional).  The doctor says that everything is going as good as it can 3 months post-surgery.  He can shoot basketball now and do wall pushups.  The doctor expects that he will be swinging a bat in October.  He will be playing basketball this winter.  I guess that he will get into some light throwing by December.  At this point in time, he appears to be a normal 16 year old kid with no ill effects.  We remain hopeful that he will return to being a strong RHP.

 

BBallMom, I hope your son's lesion is small and centrally located (meaning it has healthy cartilage surrounding it).  I think you are wise to get the surgery done; my reading of the medical literature on the subject said that rest doesn't do much for OCD.  Get used to saying "No, it wasn't Tommy John surgery."

We have already had people say "I heard G is having Tommy John"! We are all just anxious for him to have the surgery so we have a more complete idea of what is going on inside there. So frustrating because we have always been protective of his arm and followed strict pitch counts. He also has no pain, but the loss of motion is definitely there.    Only problem now is that his Dr. Is the SF Giants doc and if they keep winning our sons surgery will get pushed back a couple weeks (and of course we are Giants fans).

Son was able to have surgery on the 15th so we have started the post surgical journey. Lesion was centrally located and had good surrounding cartilage so Doctor feels really good about how everything went. They removed 2 loose bodies, performed a microfracture and he did a platelet rich plasma injection. We went back yesterday and they removed the bandages and put him in a brace, he will start PT next week and we will go back to the doctor in a month.

Glad to hear everything went well and that the lesion was centrally located.  My son's doc is extremely pleased with his recovery.  He has been cleared for BP and can do bodyweight exercises.  He is 4 months post-surgery now.  I have had to keep an eye on him during his recovery - not to encourage him to do any exercises, but to rein him in from doing too much of anything he is allowed to do.  He went a little overboard with pushups last week.  He decided to run cross-country this fall.  I think that helped satisfy his competition cravings, let him be part of a team, and I wonder if it helped his recovery by stimulating blood flow.  

Hello,

I saw this post and felt the need to create an account to share my experience with OCD. I'm sorry to hear all of the concerns and unfortunate news about this injury for a young ballplayer. My name is Matt Hernandez and I'd like to share my experience, hopefully being able to inspire those kids and parents, that it's not the end of the road or a dead end for a kids dreams. I'd consider my OCD a success, as well as something I do hold close and dearly on as an emotional matter. I feel I may possibly be someone has pitched the longest after this surgery. Being diagnosed with OCD at 14, had the surgery before my freshman year of baseball in 2005. Unfortunately, my growth plate had detached from my left elbow (throwing arm) and ended up getting a one inch screw in my elbow. Not sure if this method is still used now. It was devastating being 14 and told my odds of a full recovery were 50/50 in fully recovering in throwing terms. Continued to pitch for nearly the next 10 years and never had any problems actually never had soreness. Proper rehab and a positive attitude, I was fortunate enough to have a successful baseball career throughout high school, Division 1 and Minor league baseball. Though, oddly enough I've never had a chance or come across another person with the same injury as mine, having met hundreds and hundreds of fellow players throughout my journey, I felt I was always the only one. I hope my story inspires young players who face this injury that it is not the end of a dream and anything is possible, as I am living proof for those kids and parents who go through this injury together. 

MattyHern28 - Thanks you so much for your post. Being that my son is only 2 weeks in to a 6+ month recovery, positive news is very helpful.  It's so hard to find any long-term follow-up other than a few very vague hard to understand medical studies.  There are few places my son would rather be than on a pitchers mound and hearing stories like yours will help him believe he can return there.

Not a problem at all. It's really enjoyable and important almost like duty that I should inspire those who's shoes I've been in, and now give that hope too others, that I never had someone give me during that experience.

My elbow now is fine. Minor stiffness at first if its cold. But I was always smart about it. I took time off in the falls and played football, never played in summer leagues in college. Most likely a key factor of my longevity.

The rehab...hmm looking back I was 14 during my rehab so I'm trying to dig deep in my memory. I've become more knowledgeable of the exercises now because they became routine in college and pro ball. So I was in a hard cast from fingers to half way up my bicep for 6 weeks, after getting it off the first exercise was putting my entire arm in this fish tank like sized box of sand that was heated and almost felt like it was wet because it was churning around. It was like a Jacuzzi. I would do circular movements, like you would in a rice bucket for 15-20 minutes. They always referred to wanting my arm to be "beet red" after meaning there's a lot of circulation and blood flow. This would help get those muscles working and building over time. Then over time. I'd progress to small weighted balls and flicking them into a trampoline. I honestly don't remember my throwing program but I'd say I began from light toss 45ft. and patiently progressed back each time. Mainly focusing on the quality of the catch not the quantity of how many throws. The rehab was sort of unique, in ways similar to a tommy john but on the other hand not exactly, because I didn't have a ligament replaced just a screw drilled through my elbow. Most of the rehab was to gain movement, strength and mobility back. To be completely honest a great amount of my rehab was also strengthening my shoulder, there were a lot of rotator cuff exercises.  For example, facing the wall doing circular motions with a towel. Bouncing a fitness ball overhead against the wall. Laying on my side, rolled up towel under my armpit, 2.5-5lb weight in my hand and slowly lifting up and down at a 90 degree angle. The shoulder should never be forgotten about, often guys who had a shoulder injury the next issue is their elbow such as tommy john. You hardly see it in reverse order, going from an elbow to the shoulder. I hope that makes sense. Information on All these basic exercises can be easily found online now a days. 

There are many websites you can find information, but in my opinion the best out there is my trainer Lee Fiocchi, from Dynamic Sports Training. His company ran our team at U of Houston and trained along his other athletes such as Carl Crawford, Scott Kazmir, Trevor Bauer and Michael Bourn. Zero arm injuries at the school in his 3 years, his arm programs blow the one's we did in the Angels organization out of the water. As a result pitchers were dropping like flies with injuries.

 

Haha well long story short I'm the middle of there boys. Only left hander in the family. But Im naturally right handed hitter. I started to switch hit at 10. Lance Berkman was my guy haha. But it was natural for me, switch hit up to college and went straight left handed as a two way player. But now i just put L/L ever since college and pro ball. 
(Haha I was a cage rat. Lots of tee work everyday. It was a lot of work to not favor a side)

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