Classification, Treatment, and Outcome of Osteochondritis Dissecans of the Humeral Capitellum

Takahara, Masatoshi; Mura, Nariyuki; Sasaki, Junya; Harada, Mikio; Ogino, Toshihiko

doi:10.2106/jbjs.f.00622

Cited by 175 publications

(146 citation statements)

References 25 publications

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“…For example, osteochondritis dissecans of the capitellum is one of the leading causes of long-term elbow disability in young athletes. [36][37][38] Trochlear and trochlear notch chondromalacia occurs in throwing athletes with medial instability, 39 while osteochondral injury of the capitellum is a feature of posterolateral rotatory instability. 40 Capitellar cartilage injury also occurs in about 10% of patients with radial head fracture.…”

Section: Discussionmentioning

confidence: 99%

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Elbow MR arthrography with traction

Lee

Griffith

Yuen

et al. 2016

BJR

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Section: Discussionmentioning

confidence: 99%

“…These features are generally assessed by MRI. 37,38,42 Direct MRA of the elbow improves the diagnostic performance of conventional MRI in detecting and grading cartilage injuries. 3,8 However, MRA of the The amount of contrast dispersion significantly improved at the radiocapitellar joint space after traction (p , 0.05, in bold text).…”

Section: Discussionmentioning

confidence: 99%

Elbow MR arthrography with traction

Lee

Griffith

Yuen

et al. 2016

BJR

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“…Since surgical intervention may not be protective against degenerative changes [20], quality imaging studies are needed to differentiate between stable and unstable OCD lesions. Stable lesions can be managed successfully with non-operative measures including rest and activity modification.…”

Section: Classificationmentioning

confidence: 99%

“…It has been reported to occur in roughly 4 out of every 1000 males [19]. A large percentage of cases involve Little League pitchers, and at the time of presentation, many adolescents have already undergone physeal closure [20]. Kida et al evaluated 2433 baseball players with a mean age of 14 years old involved in junior high and high school baseball teams.…”

Section: Introductionmentioning

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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“…13 Lesion stability is further classified based on a combination of skeletal maturity, MRI imaging, range of motion, and arthroscopic findings. 25 Stable lesions are found in patients with open physes, nearly normal range of motion, and an intact cartilage rim on MRI and are initially treated conservatively. Surgery is indicated in the presence of unstable lesions, loose bodies, mechanical symptoms, and stable lesions that have failed 6 months of conservative management.…”

mentioning

confidence: 99%