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<p>Osteochondrosis dissecans (OD) is defined as a&#xa0;focal idiopathic pathological change in the subchondral bone associated with a&#xa0;risk of instability and discontinuity of the adjacent articular cartilage. As a&#xa0;result of complete separation of the fragment, there is a&#xa0;risk of clinical decompensation, including joint locking and restricted movement, and potentially the development of osteoarthritis. Overall, stable lesions with a&#xa0;small size, an absence of subchondral cyst formation, no enlargement of the radial head, an open growth plate, and a&#xa0;short duration of symptoms show a&#xa0;high potential for consolidation. Progressive ossification within the first 3&#xa0;months is also considered a&#xa0;positive prognostic factor for conservative treatment, as is compliance with activity restrictions (AR). Surgical procedures are classified into reparative (arthroscopic fragment removal with or without bone marrow stimulation techniques, fragment fixation), regenerative (“minced cartilage,” autologous chondrocyte transplantation), and reconstructive therapies (osteochondral autograft or allograft transfer, wedge osteotomies). Fragment size, stability, circumferential support by healthy cartilage (“containment”), and the location of the defect (centralized, lateral localized, lateral widespread type) determine the choice of treatment as well as the surgical approach. To optimize cartilage and bone healing, traditional techniques are increasingly being supplemented by biological augmentation, particularly platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC). Initial case series involving the elbow demonstrated a&#xa0;potential improvement in the quality of regeneration and&#xa0;more rapid reduction of symptoms; however, robust long-term data and randomized trials are lacking.</p>

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Behandlung osteochondraler Läsionen am kindlichen Ellenbogen

  • 期刊论文

  • 发表日期：

    2026年7月29日

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  • Kathi Thiele,
  • Anton Schmidt,
  • Stephan Pauly,
  • Pierre Hepp,
  • Maria Elze

摘要

Osteochondrosis dissecans (OD) is defined as a focal idiopathic pathological change in the subchondral bone associated with a risk of instability and discontinuity of the adjacent articular cartilage. As a result of complete separation of the fragment, there is a risk of clinical decompensation, including joint locking and restricted movement, and potentially the development of osteoarthritis. Overall, stable lesions with a small size, an absence of subchondral cyst formation, no enlargement of the radial head, an open growth plate, and a short duration of symptoms show a high potential for consolidation. Progressive ossification within the first 3 months is also considered a positive prognostic factor for conservative treatment, as is compliance with activity restrictions (AR). Surgical procedures are classified into reparative (arthroscopic fragment removal with or without bone marrow stimulation techniques, fragment fixation), regenerative (“minced cartilage,” autologous chondrocyte transplantation), and reconstructive therapies (osteochondral autograft or allograft transfer, wedge osteotomies). Fragment size, stability, circumferential support by healthy cartilage (“containment”), and the location of the defect (centralized, lateral localized, lateral widespread type) determine the choice of treatment as well as the surgical approach. To optimize cartilage and bone healing, traditional techniques are increasingly being supplemented by biological augmentation, particularly platelet-rich plasma (PRP) and bone marrow aspirate concentrate (BMAC). Initial case series involving the elbow demonstrated a potential improvement in the quality of regeneration and more rapid reduction of symptoms; however, robust long-term data and randomized trials are lacking.