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Our 13-year old son developed a problem in his elbow called osteochondritis dissecans from pitching too many baseball games. The orthopedic surgeon is recommending an operation called autologous osteochondral grafting What can you tell us about this?

Osteochondritis dissecans is a problem with the cartilage and layer of bone just under the cartilage. The cartilage and bone separate from each other and sometimes pull away from the main bone, too. The stress of repetitive force from throwing balls is a common cause of this problem.

Treatment is designed to reduce pain and return the athlete to his previous level of play. Preventing arthritis is a long-term goal. If you've spent six months or more trying to get a handle on this problem with poor results, then surgery is the next step.

There are different ways to treat this problem surgically. It sounds like your son is having an autologous osteochondral mosaicplasty. Loose pieces of bone and cartilage are removed. Holes are drilled where the damage occurred. Bone plugs are taken from the bottom part of the femur (thigh bone) and inserted into the holes.

Autologous means the patient donated the bone graft to himself. 'Osteo' refers to bone and 'chondral' refers to the cartilage. Mosaicplasty is the grafting of osteochondral tissue to help the healing process.

Graft rejection is always a concern with donated tissue. With mosaicplasty, there's a high rate of graft survival to ensure success. The main problem with this procedure is pain and swelling at the donor site. In time, this improves and healing completes in both the graft and the donor sites.

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