Osteochondritis dissecans of the elbow

Osteochondritis dissecans of the elbow remains one of the leading causes of permanent elbow disability in adolescents and young adults engaged in throwing sports or gymnastics. The insidious onset of lateral elbow pain and restriction of full extension should alert the physician and prompt further investigation. Early recognition and appropriate treatment may allow for the prevention of long-term sequelae. Conservative care following early detection provides the best opportunity for a complete recovery. Surgical management at this point consists primarily of excision or removal of the osteochondral fragment with drilling or burring of the base of the lesion. Prognosis is fair with approximately half of all patients experiencing chronic pain or limitation of motion in the elbow. Research efforts are currently focusing on the treatment of established articular surface defects. Newer procedures such as the transplantation of osteochondral, perichondral, and periosteal tissues, chondrocyte transplantation, and the biochemical manipulation of the chondrocyte environment may provide us with exciting new approaches to an old problem. Osteochondritis dissecans of the elbow continues to present a difficult challenge to the treating physician. The current literature provides very little guidance for the clinician but active and innovative investigations into the treatment of articular cartilage defects may soon provide the answers.