Long Term Outcome of Osteochondritis Dissecans of the Humeral Capitellum

Takahara, Masatoshi; Ogino, Toshihiko; Sasaki, Isao; Kato, Hiroyuki; Minami, Akio; Kaneda, Kiyoshi

doi:10.1097/00003086-199906000-00014

Cited by 166 publications

(145 citation statements)

References 29 publications

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“…Although various surgical options have been advocated to treat advanced capitellar osteochondritis dissecans lesions, these procedures have been shown to provide only temporary relief of symptoms, and osteoarthritis can still result [1][2][3][4][5] . One way to achieve satisfactory long-term outcomes may be to resurface these lesions with hyaline cartilage.…”

Section: Introductionmentioning

confidence: 99%

Autologous Osteochondral Mosaicplasty for Osteochondritis Dissecans of the Elbow in Teenage Athletes

Iwasaki¹,

Kato²,

Ishikawa³

et al. 2010

Journal of Bone and Joint Surgery

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DISCLOSURE:The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. 91-A, pp. 235991-A, pp. -66, October 2009 ABSTRACT FROM THE ORIGINAL ARTICLE BACKGROUND: Although autologous osteochondral mosaicplasty is widely used as a procedure for osteochondritis dissecans lesions, the effectiveness of this procedure in elbow lesions remains unclear. Our aim was to clarify the surgical efficacy of mosaicplasty for teenage athletes with advanced lesions of capitellar osteochondritis dissecans.

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Section: Introductionmentioning

confidence: 99%

Autologous Osteochondral Mosaicplasty for Osteochondritis Dissecans of the Elbow in Teenage Athletes

Iwasaki¹,

Kato²,

Ishikawa³

et al. 2010

Journal of Bone and Joint Surgery

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“…Despite these good short-term results, long-term studies have shown rates of osteoarthritis of the radiocapitellar joint as high as 61%, and 42% of patients were symptomatic at 23 years. 12,13 Techniques that incorporate drilling, microfracture, or abrasion chondroplasty result in the formation of fibrocartilage within the OCD lesion. 6 Because of poor long-term outcomes with less durable fibrocartilage, multiple authors have promoted autologous osteochondral transfer.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Treatment of Capitellum Osteochondritis Dissecans With Micronized Allogeneic Cartilage Scaffold

Caldwell

Auerbach

Pearson

2017

Arthroscopy Techniques

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Osteochondritis dissecans (OCD) of the capitellum is a common disorder that causes pain and functional limitation in the adolescent elbow. Although conservative management is the first line of treatment, surgical intervention is usually recommended for patients with persistent mechanical symptoms, loose bodies, or unstable lesions. Elbow arthroscopy has become the gold standard to evaluate and treat symptomatic OCD lesions. Arthroscopic debridement and bone marrow stimulation have been shown to yield good short-term results. Unfortunately, long-term follow-up has shown less favorable outcomes, with degenerative changes frequently documented. Current marrow stimulation techniques promote the formation of fibrocartilage, which is known to be less durable than hyaline cartilage. We describe an arthroscopic technique of debridement and drilling supplemented with a micronized allogeneic cartilage scaffold to address OCD lesions of the capitellum in an effort to promote hyaline cartilage formation.

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“…Factors associated with a good prognosis include early lesions, patients with open capitellar growth plates [26], and localized subchondral bone flattening without fragmentation [27,28]. However, healing with non-operative management becomes very unlikely in those with closed growth plates and lesion instability even without displacement [26,28,27,29].…”

Section: Classificationmentioning

confidence: 99%

Elbow Injuries in the Adolescent Thrower

Griffith

Kercher

Willimon

et al. 2018

Curr Rev Musculoskelet Med

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Purpose of Review With an increasing rate of adolescent elbow injuries, especially in throwing athletes, the purpose of this review is to investigate the current literature regarding the diagnosis, treatment, and non-operative and operative outcomes of medial epicondyle fractures, ulnar collateral ligament repair, osteochondritis dissecans of the elbow, and olecranon stress fractures. Recent Findings Acceptable outcomes with both non-operative and operative treatments of medial epicondyle fractures have been reported, with surgical indications continuing to evolve. Unstable osteochondritis dissecans lesions, especially in patients with closed growth plates, require operative fixation, and emerging open and arthroscopic techniques including lesion debridement, marrow stimulation, autograft transfer, and allograft transplantation are described with good outcomes. Ulnar collateral repair has emerged as an exciting treatment option for an avulsion of either end of the ligament in young throwing athletes, with faster rehabilitation times than traditional ulnar collateral ligament reconstruction. Olecranon stress fractures are increasing in prevalence, and when a non-operative treatment course is unsuccessful, athletes have a high return-to-play rate after percutaneous cannulated screw placement. Summary With proper indications, non-operative and operative treatment modalities are reported with a high return-to-play and acceptable clinical outcomes for common elbow injuries, including medial epicondyle fractures, ulnar collateral ligament repair, osteochondritis dissecans of the elbow, and olecranon stress fractures, in adolescent throwing athletes. Further research is needed to better define treatment algorithms, surgical indications, and outcomes.

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Long Term Outcome of Osteochondritis Dissecans of the Humeral Capitellum

Cited by 166 publications

References 29 publications

Autologous Osteochondral Mosaicplasty for Osteochondritis Dissecans of the Elbow in Teenage Athletes

Autologous Osteochondral Mosaicplasty for Osteochondritis Dissecans of the Elbow in Teenage Athletes

Arthroscopic Treatment of Capitellum Osteochondritis Dissecans With Micronized Allogeneic Cartilage Scaffold

Elbow Injuries in the Adolescent Thrower

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