RARE DISEASE
Osteochondritis dissecans
Osteochondritis dissecans
Osteochondritis dissecans
Synonyms: König disease
Synonyms: König disease
Synonyms: König disease
Drug discovery
2
drugs
With orphan designations
Overview
Osteochondritis dissecans (OCD) is an acquired idiopathic lesion of subchondral bone, causing cartilage instability or detachment, most commonly in the knee (66.2% of cases), followed by elbow and ankle joints [1][4][14]. It primarily affects adolescents (10-20 years), with symptoms including activity-related pain, swelling, locking, and restricted motion [6][7][16]. Diagnosis combines radiographs and MRI to assess lesion stability [16][17]. Stable lesions in skeletally immature patients often heal with rest, while unstable or refractory cases require surgical intervention [1][5][13]. Untreated OCD increases osteoarthritis risk [2][11][16].
Population
Burden
Annual incidence: 15-30/100,000; knee OCD prevalence 2.3-31.6/100,000 [4][14][19].
35% require surgery; 63% experience symptom recurrence post-microfracture at 10 years [13][18].
Economic impact: 6-month activity restriction reduces sports participation, while untreated cases accelerate osteoarthritis onset by 10-20 years [2][10][16].
Therapies
Conservative: Activity restriction (2-6 months), bracing, and physical therapy for stable lesions (50-67% success rate in juveniles) [1][13][18].
Surgical: Drilling (stable lesions), fixation with bioabsorbable screws (unstable lesions), or osteochondral grafts for detached fragments [5][13][16].
AAOS 2023 guidelines recommend early surgical consideration for salvageable unstable lesions in skeletally mature patients [5].
Categories: rare bone diseases, rare systemic and rheumatological diseases
Research Papers
1,551 drug discovery papers about Osteochondritis dissecans, with 2 first-in-class and 3 next-in-class emerging drug candidates forecasted to outperform the average preclinical success rate. Recent publications:
1,551 drug discovery papers about Osteochondritis dissecans, with 2 first-in-class and 3 next-in-class emerging drug candidates forecasted to outperform the average preclinical success rate. Recent publications:
2026-06-28 | Extracellular Matrix With Bone Marrow Aspirate Concentrate for Osteochondritis Dissecans of the Capitellum in Adolescents
Abstract Capitellar osteochondritis dissecans is most frequently encountered in overhead and tumbling adolescent athletes. Traditional management with abrasion chondroplasty or microfracture results in fibrocartilage formation and variable return to sport rates, whereas osteochondral autograft transfer system or osteochondral allograft transplantation may incur unnecessary morbidity for small, shallow lesions. This article therefore describes the application of a biologic scaffold composed of extracellular matrix combined with bone marrow aspirate concentrate to unstable, shallow (<6‐7 mm), but contained capitellar osteochondritis dissecans lesions through an anconeus‐splitting arthrotomy. This technique provides excellent exposure of the capitellum and offers the potential for biologically favorable hyaline‐like cartilage regeneration. With promising early clinical results, this approach is more easily implemented even for those without extensive elbow arthroscopy experience and represents a favorable middle‐ground between microfracture and osteochondral autograft transfer system/ osteochondral allograft for adolescent athletes with capitellar osteochondritis dissecans lesions.
2026-06-01 | Tumbling Athletes Sustain Highest Rate of Bilateral Elbow Osteochondritis Dissecans Lesions and May Benefit from Screening
Background: Osteochondritis dissecans (OCD) lesions commonly present at the capitellum, particularly among athletes who participate in overhead sports or impact load through their upper extremity. However, bilateral elbow OCD lesions are rare and can significantly impact sport participation and elbow function. Previous studies have shown unique capitellar OCD characteristics are associated with specific sport participation – gymnasts tend to have posterior lesions with lesser lesion containment. Hypothesis: Tumbling athletes (gymnasts, cheerleaders, dancers) have an increased propensity for bilateral OCD lesions and would benefit from screening at the time of first presentation. Methods: A retrospective review was performed of a consecutive series of pediatric and adolescent patients with elbow OCD lesions who presented to a single tertiary care pediatric hospital, identified using CPT and ICD codes. Data regarding patient demographics, sports participation, lesion characteristics on radiographs and MRI, and timeline of presentation were collected for patients with bilateral lesions. Descriptive statistical analyses was performed to compare unilateral and bilateral lesions. Results: A total of 279 consecutive patients from 2009-2025 with a diagnosis of elbow OCD and a mean age of 13.4 (8.0-19.1) years were included, of which 10.3% (n=29) were determined to have bilateral lesions. Patients with bilateral lesions were younger compared to unilateral lesions (12.9 vs 13.4, p<0.001). Compared to unilateral lesions, bilateral lesions were observed at higher rates among females (79.43% vs 38.2%, p<0.001) and in tumbling athletes (72.4% vs 32.8%, p<0.001). Bilateral lesions were noted at a mean sagittal inclination angle of 38 (±14.1) degrees, indicating that these lesions tend to occur on the posterior aspect of the capitellum. Of the 29 bilateral patients, only 7 (24.1%) had bilateral lesions concomitantly identified at initial presentation while 22 (75.9%) had their bilateral lesions found sequentially. The majority (26/29, 90.0%) of the secondary lesions were identified after becoming symptomatic, whereas 3 (10.3%) secondary lesions were found incidentally. Conclusion: In our series, bilateral elbow OCD occurred at an incidence of 10.3%; however, the incidence was over double in tumbling athletes. Bilateral lesions were more common in young females. Due to the high level of prevalence in tumbling athletes, consideration should be given to contralateral elbow screening at initial presentation in tumbling athletes, and screening should be promptly performed at the initiation of contralateral symptoms.
2026-06-01 | Glenoid Osteochondritis Dissecans in 9 Baseball Players: Arthroscopic Management and Radiographic Outcomes
Glenoid osteochondritis dissecans (OCD) is a rare condition seen occasionally in throwing athletes. Early diagnosis using conventional radiography is challenging. The aim of this study was to report on a series of baseball players receiving treatment for glenoid OCD. This retrospective case series included nine baseball players with glenoid OCD who underwent arthroscopic surgery with a minimum of one year follow-up. Plain radiographs were routinely obtained in the arm-elevated position (140–150°) to compare glenoid morphology between the throwing and non-throwing shoulders. Computed tomography (CT) and magnetic resonance imaging (MRI) were used for definitive diagnosis and lesion assessment. Surgical procedures were selected based on intraoperative arthroscopic findings, including trans-articular drilling for stable lesions and bone marrow stimulation for unstable lesions. The mean age at surgery was 16.6 ± 1.7 years, with a mean follow-up of 30.5 ± 12.7 months. All lesions were located in the posterior glenoid. Radiographic healing was confirmed on postoperative CT at a mean of 12.0 ± 4.2 months, with no progression observed in any case. Eight of nine patients (89%) successfully returned to play (RTP) at their preinjury competitive level at a mean of 9.2 ± 4.1 months postoperatively. Arm-elevated radiographs comparing both shoulders may serve as a useful adjunctive screening method for detecting glenoid OCD in throwing athletes. Arthroscopic treatment tailored to lesion stability was associated with a favorable RTP rate in this small case series; however, careful consideration of surgical timing is necessary.
2026-06-28 | Extracellular Matrix With Bone Marrow Aspirate Concentrate for Osteochondritis Dissecans of the Capitellum in Adolescents
Abstract Capitellar osteochondritis dissecans is most frequently encountered in overhead and tumbling adolescent athletes. Traditional management with abrasion chondroplasty or microfracture results in fibrocartilage formation and variable return to sport rates, whereas osteochondral autograft transfer system or osteochondral allograft transplantation may incur unnecessary morbidity for small, shallow lesions. This article therefore describes the application of a biologic scaffold composed of extracellular matrix combined with bone marrow aspirate concentrate to unstable, shallow (<6‐7 mm), but contained capitellar osteochondritis dissecans lesions through an anconeus‐splitting arthrotomy. This technique provides excellent exposure of the capitellum and offers the potential for biologically favorable hyaline‐like cartilage regeneration. With promising early clinical results, this approach is more easily implemented even for those without extensive elbow arthroscopy experience and represents a favorable middle‐ground between microfracture and osteochondral autograft transfer system/ osteochondral allograft for adolescent athletes with capitellar osteochondritis dissecans lesions.
2026-06-01 | Tumbling Athletes Sustain Highest Rate of Bilateral Elbow Osteochondritis Dissecans Lesions and May Benefit from Screening
Background: Osteochondritis dissecans (OCD) lesions commonly present at the capitellum, particularly among athletes who participate in overhead sports or impact load through their upper extremity. However, bilateral elbow OCD lesions are rare and can significantly impact sport participation and elbow function. Previous studies have shown unique capitellar OCD characteristics are associated with specific sport participation – gymnasts tend to have posterior lesions with lesser lesion containment. Hypothesis: Tumbling athletes (gymnasts, cheerleaders, dancers) have an increased propensity for bilateral OCD lesions and would benefit from screening at the time of first presentation. Methods: A retrospective review was performed of a consecutive series of pediatric and adolescent patients with elbow OCD lesions who presented to a single tertiary care pediatric hospital, identified using CPT and ICD codes. Data regarding patient demographics, sports participation, lesion characteristics on radiographs and MRI, and timeline of presentation were collected for patients with bilateral lesions. Descriptive statistical analyses was performed to compare unilateral and bilateral lesions. Results: A total of 279 consecutive patients from 2009-2025 with a diagnosis of elbow OCD and a mean age of 13.4 (8.0-19.1) years were included, of which 10.3% (n=29) were determined to have bilateral lesions. Patients with bilateral lesions were younger compared to unilateral lesions (12.9 vs 13.4, p<0.001). Compared to unilateral lesions, bilateral lesions were observed at higher rates among females (79.43% vs 38.2%, p<0.001) and in tumbling athletes (72.4% vs 32.8%, p<0.001). Bilateral lesions were noted at a mean sagittal inclination angle of 38 (±14.1) degrees, indicating that these lesions tend to occur on the posterior aspect of the capitellum. Of the 29 bilateral patients, only 7 (24.1%) had bilateral lesions concomitantly identified at initial presentation while 22 (75.9%) had their bilateral lesions found sequentially. The majority (26/29, 90.0%) of the secondary lesions were identified after becoming symptomatic, whereas 3 (10.3%) secondary lesions were found incidentally. Conclusion: In our series, bilateral elbow OCD occurred at an incidence of 10.3%; however, the incidence was over double in tumbling athletes. Bilateral lesions were more common in young females. Due to the high level of prevalence in tumbling athletes, consideration should be given to contralateral elbow screening at initial presentation in tumbling athletes, and screening should be promptly performed at the initiation of contralateral symptoms.
2026-06-01 | Glenoid Osteochondritis Dissecans in 9 Baseball Players: Arthroscopic Management and Radiographic Outcomes
Glenoid osteochondritis dissecans (OCD) is a rare condition seen occasionally in throwing athletes. Early diagnosis using conventional radiography is challenging. The aim of this study was to report on a series of baseball players receiving treatment for glenoid OCD. This retrospective case series included nine baseball players with glenoid OCD who underwent arthroscopic surgery with a minimum of one year follow-up. Plain radiographs were routinely obtained in the arm-elevated position (140–150°) to compare glenoid morphology between the throwing and non-throwing shoulders. Computed tomography (CT) and magnetic resonance imaging (MRI) were used for definitive diagnosis and lesion assessment. Surgical procedures were selected based on intraoperative arthroscopic findings, including trans-articular drilling for stable lesions and bone marrow stimulation for unstable lesions. The mean age at surgery was 16.6 ± 1.7 years, with a mean follow-up of 30.5 ± 12.7 months. All lesions were located in the posterior glenoid. Radiographic healing was confirmed on postoperative CT at a mean of 12.0 ± 4.2 months, with no progression observed in any case. Eight of nine patients (89%) successfully returned to play (RTP) at their preinjury competitive level at a mean of 9.2 ± 4.1 months postoperatively. Arm-elevated radiographs comparing both shoulders may serve as a useful adjunctive screening method for detecting glenoid OCD in throwing athletes. Arthroscopic treatment tailored to lesion stability was associated with a favorable RTP rate in this small case series; however, careful consideration of surgical timing is necessary.
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Drug Discovery Landscape
2 orphan drug designations for Osteochondritis dissecans.
2 orphan drug designations for Osteochondritis dissecans.
Drug | Therapy type | Regulator | Orphan designation | Approval | Sponsor |
|---|---|---|---|---|---|
allogeneic human chondrocytes | cell therapies | FDA | 2024-12-30 | — | Vanarix SA |
recombinant human platelet derived growth factor-BB | proteins | FDA | 2010-08-06 | — | Biomimetic Therapeutics, Inc. |
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