Arthroscopic Treatment of Capitellum Osteochondritis Dissecans With Micronized Allogeneic Cartilage Scaffold

Caldwell, Paul E.; Auerbach, Brett; Pearson, Sara E.

doi:10.1016/j.eats.2017.04.007

Cited by 12 publications

(8 citation statements)

References 18 publications

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“…Initial satisfactory outcomes after simple debridement, microfracture or drilling, and removal of loose bodies may not endure over time [3]. Thus, some authors have attempted to augment marrow-stimulating techniques with such measures as allogeneic cartilage scaffolds in an effort to promote a more hyaline-like repair and minimize long-term degenerative changes [39]. Many others depend on the long-used method of fragment fixation to achieve this; fragment fixation has historically produced reliably good outcomes and rates of union [35][36][37].…”

Section: Resultsmentioning

confidence: 99%

Osteochondritis dissecans lesions of the capitellum in overhead athletes: a review of current evidence and proposed treatment algorithm

Logli

Bernard

O’Driscoll

et al. 2019

Curr Rev Musculoskelet Med

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Purpose of the Review To review the most recent literature on osteochondritis dissecans (OCD) lesions of the capitellum in overhead athletes and describe a treatment algorithm based on current best evidence and surgeon experience. Recent Findings Recent research has included larger cohort studies with longer follow-up as well as quality systematic reviews and meta-analyses. These studies have focused on understanding how lesion characteristics such as size, location, and appearance on advanced imaging can predict treatment success. Current literature continues to support nonoperative management for stable lesions. Operative intervention is generally required for unstable lesions and treatment strategies are largely dictated by lesion size and location: debridement or reparative techniques for small lesions while larger lesions or those in high-stress locations are better served by bone and/or cartilage restoration procedures. There has been a rising interest in the use of allograft materials and cellbased therapies. Summary Overhead athletes are uniquely predisposed to capitellar OCD due to the nature of forces applied to the radiocapitellar joint during repeated activity in the overhead position. Despite improvements in operative techniques, successful use of alternative graft materials, and a better understanding of how lesion characteristics influence results, there is still much to learn about this challenging disorder. Future research should focus on comparing operative techniques, refining their indications, and further developing a reliable treatment algorithm that best serves the overhead athlete. Keywords Osteochondritis dissecans (OCD). Humeral capitellum. Overhead athlete. Elbow pain. Baseball players. Gymnasts This article is part of the Topical Collection on Injuries in Overhead Athletes

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Section: Resultsmentioning

confidence: 99%

Osteochondritis dissecans lesions of the capitellum in overhead athletes: a review of current evidence and proposed treatment algorithm

Logli

Bernard

O’Driscoll

et al. 2019

Curr Rev Musculoskelet Med

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show abstract

“…Las microfracturas promueven la formación de fibrocartílago, que se sabe que es menos duradero que el cartílago hialino y esto puede condicionar malos resultados en pacientes con alta exigencia de carga de la articulación (23) . Recientemente ha sido descrita la opción quirúrgica de asociar las perforaciones con un suplemento de cartílago alogénico micronizado para promover la formación de cartílago hialino, pero aún no existe evidencia de que este método sea superior a las perforaciones simples (25) .…”

Section: Resultsunclassified

Tratamiento artroscópico de la osteocondritis disecante del codo

Delgado¹,

Medrano²,

López³

et al. 2018

REACA

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RESUMEN Objetivo: presentar conceptos básicos de etiología, exploración, clasificación de la osteocondritis disecante del codo (ODC) y el tratamiento artroscópico de la misma. Material y métodos: se realizó una búsqueda exhaustiva de literatura. Han sido revisados estudios clínicos, biomecánicos, anatómicos y de imágenes relevantes junto con artículos de revisión recientes y series de casos publicados sobre ODC y tratamiento artroscópico. Resultados: la ODC es una afección dolorosa, que a menudo afecta a los jóvenes deportistas. Se conocen la etiología, los factores de riesgo, el diagnóstico y la eficacia del tratamiento disponible. La exploración clínica y la resonancia magnética (RM) son claves para el diagnóstico. El tratamiento se basa en la clasificación de la International Cartilage Repair Society (ICRS). El tratamiento más utilizado es la resección del fragmento y microperforaciones. No hay evidencia de que un tratamiento sea superior a otro. Se han descrito mejores resultados en niños. El peor resultado se obtiene en los pacientes deportistas de alto rendimiento. Conclusiones: en estadios iniciales se debe disminuir la carga deportiva y realizar medidas conservadoras.

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“…The use of MCM has further been reported on chondral defects of the glenoid, capitellum, and tibial plateau. [21][22][23][24] However, there is limited data to guide the optimal clinical treat-ment protocol for the use of MCM, and additional laboratory studies could further enhance the current technique.…”

Section: Discussionmentioning

confidence: 99%

Effects of Micronized Cartilage Matrix on Cartilage Repair in Osteochondral Lesions of the Talus

et al. 2018

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Background The repair of osteochondral lesions remains a challenge due to its poor vascularity and limited healing potential. Micronized cartilage matrix (MCM) is dehydrated, decellularized, micronized allogeneic cartilage matrix that contains the components of native articular tissue and is hypothesized to serve as a scaffold for the formation of hyaline-like tissue. Our objective was to demonstrate in vitro that the use of MCM combined with mesenchymal stem cells (MSCs) can lead to the formation of hyaline-like cartilage tissue in a single-stage treatment model. Design In group 1 (no wash), 250 µL MCM was reconstituted in 150 µL Dulbecco's phosphate-buffered saline (DPBS) for 5 minutes. Group 2 (saline wash) included 250 µL MCM washed in 20 mL DPBS for 30 minutes, then aspirated to remove all DPBS and reconstituted in 150 µL DPBS. Group 3 (serum wash): 250µL MCM washed in 20 mL DPBS for 30 minutes, then aspirated and reconstituted in 150 µL fetal bovine serum. Each group was then added to 50 µL solution of MSC suspended in DPBS at a concentration of 1.2 × 10 cells/350 µL. After 3 weeks, the defects were extracted and sectioned to perform viability and histologic analyses. Results Stem cells without rehydration of the MCM showed almost no viability whereas near complete cell viability was seen after rehydration with serum or saline solution, ultimately leading to chondrogenic differentiation and adhesion to the MCM particles. Conclusion We have shown in this proof-of-concept in vitro study that MCM can serve as a scaffold for the growth of cartilage tissue for the treatment of osteochondral lesions.

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Arthroscopic Treatment of Capitellum Osteochondritis Dissecans With Micronized Allogeneic Cartilage Scaffold

Cited by 12 publications

References 18 publications

Osteochondritis dissecans lesions of the capitellum in overhead athletes: a review of current evidence and proposed treatment algorithm

Osteochondritis dissecans lesions of the capitellum in overhead athletes: a review of current evidence and proposed treatment algorithm

Tratamiento artroscópico de la osteocondritis disecante del codo

Effects of Micronized Cartilage Matrix on Cartilage Repair in Osteochondral Lesions of the Talus

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