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What's the prognosis for osteochondritis dissecans of the elbow? Our 13-year-old son has this from throwing balls for his dogs -- over and over and over.

Osteochondritis dissecans (OCD) is a problem encountered most often by male adolescents (teens) involved in repetitive overhead throwing activities. Young girls participating in gymnastics are the second group affected most often. Gymnasts can spend quite a bit of time engaged in activities that require repeated weight-bearing on the arms leading to OCD. In this condition, repetitive microtrauma from repeated motions of the elbow causes the articular cartilage that lines the elbow joint to separate and break into pieces. When the cartilage pulls away from the joint, it takes a layer of subchondral bone with it. Subchondral just means "under the cartilage," which describes the first layer of bone next to the articular cartilage. Most young athletes can expect to return to the sports activity of their choice (even if it's just throwing the ball for the dogs). But there's an extended period of time of physical therapy, rehab, and recovery. When full, pain free elbow motion is possible, then strengthening begins and progresses to include sports-specific training (e.g., overhead throwing). Expected results are good when the problem is caught early and the damage done is minimal. But beware that the prognosis for osteochondritis dissecans of the capitellum is not always good. Studies show that at least half of the children affected by this condition end up with arthritis and continued elbow pain, stiffness, and limitations. The prognosis seems poorest for those patients with the most severe, unstable lesions. New treatment techniques are undergoing study with hope for more promising long-term results.

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