Osteochondritis Dissecans of the Humeral Capitellum

Bradley, James P.; Petrie, Russell S.

doi:10.1016/s0278-5919(05)70270-2

Cited by 179 publications

(121 citation statements)

References 42 publications

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“…[24][25][26][27][28][29][30] Osteochondral grafting has also been used in the capitellum, talus, and femoral head, with graft viability proven with second-look arthroscopy, MRI, and biopsy. [31][32][33][34][35][36][37] The MRI of our patient at 21 months postoperative showed bone incorporation of the graft to the capitate and the presence of graft cartilage (►Fig. 7b).…”

Section: Discussionmentioning

confidence: 99%

Technique: Osteochondral Grafting of Capitate Chondrosis in PRC

Tang

Imbriglia

2013

Jnl Wrist Surg

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Proximal row carpectomy (PRC) has been shown in multiple studies to be an effective motion-preserving procedure for wrist arthritis. The operation consists of resection of the scaphoid, lunate, and triquetrum. 1 The proximal capitate and lunate fossa of the radius form the new wrist articulation, which makes the ideal patient free of degenerative changes at those articular surfaces. 2-8 Various authors, as well as the senior author, have maintained that when there is mild degeneration of these articular surfaces, PRC can still provide good to excellent results. [2][3][4][5][6]9 However, as wrist arthritis progresses, as in stage III scapholunate advanced collapse (SLAC) wrist or stage II/III scaphoid nonunion advanced collapse (SNAC) wrist, the proximal capitate becomes arthritic. With advanced degeneration, alternative surgical procedures include scaphoid excision, four-bone fusion, and wrist fusion. However, there Keywords ► osteochondral graft ► proximal row carpectomy AbstractBackground Proximal row carpectomy (PRC) is a useful treatment option for wrist arthritis, but the operation is contraindicated when there is arthritis of the capitate head. We describe a technique that involves resurfacing of a capitate that has focal chondrosis, using an osteochondral graft harvested from the resected carpal bones. Materials and Methods PRC patients who had a focal area of capitate chondrosis underwent osteochondral grafting of the capitate. Pre-and postoperative pain level, employment status, motion, grip strength, and Modified Mayo Wrist Scores (MMWS) were assessed. Postoperative Disability of the Arm, Shoulder, and Hand (DASH) scores were also calculated.

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Section: Discussionmentioning

confidence: 99%

Technique: Osteochondral Grafting of Capitate Chondrosis in PRC

Tang

Imbriglia

2013

Jnl Wrist Surg

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“…Graft material should be of similar thickness to the native articular cartilage and have a smooth articular contour [31] (Figs. 6,7,8). It has been reported that on sequential MRI, a consistent volume of reparative tissue can be demonstrat- Fig.…”

Section: Mri Of Autologous Chondrocyte Implantationmentioning

confidence: 90%

“…ACI has been performed in other joints, including the ankle, shoulder and elbow [5][6][7][8][9][10], but follow-up and outcome studies in the literature are limited for ACI performed at these sites. ACI involves transplantation of chondrocytes with the potential to reform hyaline-like articular cartilage so joint biomechanics remain unchanged [11].…”

Section: Introductionmentioning

confidence: 99%

MR imaging of autologous chondrocyte implantation of the knee

et al. 2006

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Autologous chondrocyte implantation (ACI) is a surgical technique that is increasingly being used in the treatment of full-thickness defects of articular cartilage in the knee. It involves the arthroscopic harvesting and in vitro culture of chondrocytes that are subsequently implanted into a previously identified chondral defect. The aim is to produce a repair tissue that closely resembles hyaline articular cartilage that gradually becomes incorporated, restoring joint congruity. Over the long term, it is hoped that this will prevent the progression of full-thickness articular cartilage defects to osteoarthritis. This article reviews the indications and operative procedure performed in ACI. Magnetic resonance imaging (MRI) sequences that provide optimal visualization of articular cartilage in the post-operative period are discussed. Normal appearances of ACI on MRI are presented along with common complications that are encountered with this technique.

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“…Stable lesions can be managed successfully with non-operative measures including rest and activity modification. 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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Osteochondritis Dissecans of the Humeral Capitellum

Cited by 179 publications

References 42 publications

Technique: Osteochondral Grafting of Capitate Chondrosis in PRC

Technique: Osteochondral Grafting of Capitate Chondrosis in PRC

MR imaging of autologous chondrocyte implantation of the knee

Elbow Injuries in the Adolescent Thrower

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