Outcomes and Failure Factors in Surgical Treatment for Osteochondritis Dissecans of the Capitellum

Is there any difference between open and arthroscopic treatment for osteochondritis dissecans (OCD) of the humeral capitellum: a systematic review and meta-analysis

“…In contrast, advanced OCD or unstable lesions generally require surgical management [10,29]. A variety of surgical techniques for OCD have been reported in the literatures with satisfied outcomes, such as debridement, drilling, fragment removal, fragment fixation, and autologous osteochondral mosaicplasty [16,26,[30][31][32][33]. Among these variety methods, fragment fixation should be considered when the fragment is amenable to being fixed.…”

Osteochondritis dissecans of the elbow

“…These patients responded well and healed with non-operative treatment whereas patients with unstable lesions (a closed capitellar physis, fragmentation on X-rays, and a range of motion lacking more than 20°) had better outcomes with operative intervention [37]. While Takahara and colleagues did not use MRI characteristics in their assessment of the stability of the OCD lesion, other authors have strongly advocated the use of the MRI characteristics described in the above sections to add to the stability assessment [6,7,13,19,21,22,29,32,33,38,39]. Thus, generally, the stability of a lesion is determined by the status of the capitellar physis, the size and location of the lesion, and the nature of the lesion based on imaging [19].…”

“…The radiocapitellar joint provides axial stability to the elbow with the capitellum transmitting approximately 60 % of compressive forces across it [9,22]. Overhead throwing and axial loading activities, such as gymnastics or weightlifting, generate repetitive radiocapitellar compressive forces [7,9,19,22]. In overhead throwers, repetitive shear forces are also transmitted across the radiocapitellar joint, primarily during the late cocking and early acceleration pitching phases [7,9,19,22].…”

“…Overhead throwing and axial loading activities, such as gymnastics or weightlifting, generate repetitive radiocapitellar compressive forces [7,9,19,22]. In overhead throwers, repetitive shear forces are also transmitted across the radiocapitellar joint, primarily during the late cocking and early acceleration pitching phases [7,9,19,22]. In the largest study to date, Kida et al investigated the prevalence and characteristics of capitellar OCD lesions in 2433 adolescent baseball players between the ages of 12 and 18.…”

“…Patients with capitellar OCD are usually between 11 and 17 years old and participate in repetitive overhead activities such as baseball, gymnastics, football, javelin, or overhead weightlifting [3, 7, 9, 15••, 16••, 17, 19, 20•, 21-25]. The radiocapitellar joint provides axial stability to the elbow with the capitellum transmitting approximately 60 % of compressive forces across it [9,22]. Overhead throwing and axial loading activities, such as gymnastics or weightlifting, generate repetitive radiocapitellar compressive forces [7,9,19,22].…”