What is osteochondritis dissecans (OCD)?Osteochondritis dissecans describes an uncommon disorder affecting the bone and cartilage surface of the elbow joint. This can lead to damage to the joint surface and the creation of cartilage and bone fragments.
It occurs as a result of altered blood supply to the joint surface in the elbow. This may be due to overuse in sports such as gymnastics or overhead throwing sports. It most commonly occurs in adolescents.
The reduced blood supply to the joint causes the bone to develop avascular necrosis (local bone death), which can cause loosening and damage to the overlying cartilage. This loosening may lead to some fragments becoming partially or completely detached. If they separate then this can cause further symptoms.
What are the symptoms and signs?Pain is a common feature of this disorder, especially when bending or straightening the elbow. There may be tenderness close to the area of cartilage damage and there may be an inability to fully bend or straighten the elbow. If a fragment has become detached, this can cause symptoms of catching or locking within the elbow.
How is osteochondritis dissecans diagnosed?The diagnosis is determined by the symptoms and signs in the elbow combined with special imaging investigations. An X-ray can pick up signs of bone changes and large loose fragments. An MRI scan is more sensitive in picking up signs of OCD and can also offer some clues as to the nature of the remaining blood supply and potential for any healing.
How is it treated?In many cases, simple rest, analgesia and avoidance of certain activities are all that is needed. In cases where there is near complete or complete detachment of the bone and cartilage fragment, surgery may be required. This can be done via keyhole (arthroscopic) techniques, open surgery or a combination of the two.
What are the potential complications?The complications of surgery include infection, bleeding and nerve injury. If the OCD does not heal there can be progression in the disease with the osteochondral (bone and cartilage) lesion can detach from the surrounding bone, pain and clicking usually follow this.
A big thank you to Simon and his team for their care, patience and perseverence looking after me through all stages of both shoulder and elbow surgery.
Since the shoulder stabilisation I have continued my sailing and fitness training without the worry that my shoulder might dislocate; and I don’t have to think twice whether my ulnar nerve will hinder any progression in my sports.
With their amazing help, I’ve been able to get back to sailing competatively and am now a double National champion.
After multiple shoulder dislocations Charlie helped me set a route for recovery, which has been nothing but smooth sailing. Surgery went successfully and I am well on my way to playing the sports I was previously. Would highly recommend.
Simon successfully operated on my frozen left shoulder in 2012 with fantastic results. This year he has overseen and advised treatment for my frozen right shoulder (via hydrodilation injection). His unrivalled experience in orthopaedic shoulder treatments, coupled with his reassuring bedside manner and excellent results, gave me huge confidence throughout. I’m hugely grateful to have my quality of life back and wouldn’t hesitate to recommend his services. Thank you Simon.
I had suffered with a painful shoulder and pins and needles for three years following a right shoulder fracture and failed half joint replacement prior to meeting Mr Pennington. He explained the situation in a way I could relate to and I’m delighted to say my revision shoulder replacement has gone well and for the first time in years I can use my arm and am pain free. I was even able to walk my daughter down the aisle 3 months after surgery! Many thanks.
I would like to thank Charlie Talbot and his team for the operations performed on both my shoulders and also the aftercare put in place after my operations. I have played golf since I was 12 years of age and thought at one point that I would never get back to playing again. Charlie was always very positive and told me that he would get me playing golf again. Well, I have now been playing golf for nearly 2 years. Before surgery I had a handicap of 12 and I am now down to 9, not bad at the age of 68. So many many thanks.
I had PRP injections into my right elbow last year and within 3 months I was pain free, a year on it is more or less 100% better. Fabulous I would recommend it to anyone with Tennis Elbow, in fact I have gone back again this year to get my left elbow done. Thanks Simon.
Mr Pennington I really wanted you to know how very thankful I am for the excellent care & treatment you and your staff gave me. It really meant a lot that you were so clear, friendly & professional and listened to me – so thank you again.
After more than four decades of shoulder problems with a total of three surgeries the full shoulder replacement surgery by Mr. Talbot has changed my life beyond expectations. I am now able bodied for the first time in years and pain free.
Thank you to Mr Boyle and team for the excellent care and attention both before and after Replacement Shoulder surgery, using the Tornier Simpliciti procedure. After very many months of severe pain and lack of movement I was pain free from day one. Now, after nine weeks, the shoulder and arm movement continues to improve, beyond expectation, with physiotherapy and exercise. I am extremely grateful for all the continuing care.
Following two years of recurrent problems with my left shoulder I was recommendedto Consult Mr Neil Pennington. I had the opportunity to have my surgery quickly and at my convenience, this fitted well around my professional and home commitments. The surgery was carried out as a day case procedure and Mr Pennington visited me following the surgery to explain everything. My operation was a minimally invasive procedure so my recovery was straightforward with only a few restrictions; in fact I was encouraged to keep my shoulder moving. I was driving and back to work after 2 weeks – after 2 years of pain and sleep disturbance I found this operation to be life changing! I found Mr Pennington to be a very professional and compassionate surgeon and he is surrounded by a whole team of professionals that gave me the utmost confidence in the care and treatment I received.
I would like to thank Mr. Talbot and the amazing team of nurses, physiotherapists and support staff for their care and support during my recent visit to the Duchy Hospital, Harrogate, for a replacement shoulder. The care and attention I received was unparalleled. The pain free movement I now have has changed my life.