Accessibility of osteochondral lesion at the capitellum during elbow arthroscopy: an anatomical study

Abstract

Introduction Osteochondrosis dissecans (OCD) at the capitellum is a common pathology in young patients. Although arthroscopic interventions are commonly used, there is a lack of information about the accessibility of the defects during elbow arthroscopy by using standard portals. Materials and methods An elbow arthroscopy using the standard portals was performed in seven fresh frozen specimens. At the capitellum, the most posterior and anterior cartilage surface reachable was marked with K-wires. Using a newly described measuring method, we constructed a circular sector around the rotational center of the capitellum. The intersection of K-wire “A” and “B” with the circular sector was marked, and the angles between the K-wires and the Rogers line, alpha angle for K-Wire “A” and beta angle for K-wire “B”, and the corridor not accessible during arthroscopy was digitally measured. Results On average, we found an alpha angle of 53° and a beta angle of 104°. Leaving a sector of 51° which was not accessible via the standard portals during elbow arthroscopy. Conclusion Non-accessible capitellar lesions during elbow arthroscopy should be considered preoperatively, and the informed consent discussion should always include the possibility of open procedures or the use of flexible instruments. Level of Evidence 4.