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.