Capitellar Osteochondritis Dissecans (OCD)

Yes - I sent you a PM.

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.

lex eagle - Thank you for advice, I am glad to hear that your son has been able to continue playing and it is great to hear the arm is feeling better than ever, that will be encouraging words for my friends who are currently dealing with this.

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?

Our doc was recommending microfracture surgery - is that what your doc is talking about?

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

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

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.

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.

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. 

My son had the debridement and microfracture surgery yesterday.  The surgeon reported no complications.  He said that the prognosis is good because the lesion was centrally located with good cartilage surrounding it.  

How long is your son out from baseball??? How long will he have to do PT??? I'm glad everything went well!

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.  

Good Luck and I hope everything goes well!!!

Southsidedad,

How is your sons recovery going???? I hope all is going well!

 

He has gone through pt, has 100% range of motion and has strengthened the forearm and upper arm muscles.  We return to the doc tomorrow for a followup.  Hopefully he will be cleared for some more activities.

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.  

So quick question southsidedad - when your son ran cross-country did he wear a hinged brace? My husband and son we're talking about things he can do while he is recovering and running came up. Just makes me so nervous with the possibility of falling.

He did not wear a brace because he was 2 months post surgery when XC got going.  I think that running on a relatively smooth surface at a controlled pace will be fine without the brace.  Stay away from the trails and the hard paces for now.

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. 

Hello MattyHern28,

Thanks for the encouraging news!!! What type of rehab did you have and how is your elbow now????

Thank you for your time!!!!

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.

 

Thanks again Matt! I too will share your success with my son! Thank you for sharing your experience on here and giving us hope!

Once again. Not a problem at all. I'll be keeping up with this forum for as long as it's up. Following everyone's progress and here for any advice. Good luck to all parents, but most importantly yalls kids, and I wish everyone of yall the best and a healthy recovery. God bless!

Matty,

Did your elbow effect your swing any????

Thanks!

how early did you start hitting????

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)

That's good to hear your hitting did not effect your elbow. How long after your surgery were you able to lift weights and bear weight on your elbow????

Well it was my top hand hitting righty. It was uncomfortable. So it actually allowed me to get alot of swings lefty my freshman year. It was more comfortable as the bottom hand from then left side. I have a verybl unique story ha

They don't drill a 1 inch screw in anymore correct? Haha I'm sure its microscopic?

yes, I think the first choice is microfracture.

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

Thanks again for your help Matt!!! I truly appreciate it!!!!

 

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

Did the "catching" or "locking" go away immediately after surgery or did it take some time?  I believe that the "catching" or "locking" is caused by loose bodies or fragments in the elbow.

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.  

That's awesome!!!! Congratulations to you and your son!!!!

God Bless!!

Quick Questions southsidevadad. Has your son been cleared to do pushups, weights and other weight bearing exercises for his elbow???

Thank you for your time!

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.

 

That's awesome southsidevadad!!! I'm glad to hear about your son improving!!!! Is he hitting as well????

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! 

First game back yesterday and everything went fine!  The elbow is completely normal today - no tenderness or stiffness.  We will keep the stints short and continue to monitor him closely.

Just wondered if there are doctors in the Houston area that are familiar with this condition - my son was just diagnosed and we will hear next week if surgery will be recommended.  Thanks -