Costal osteochondral autograft for reconstruction of advanced-stage osteochondritis dissecans of the capitellum

Nishinaka, Naoya; Tsutsui, Hiroaki; Yamaguchi, Ken; Uehara, Takeki; Nagai, Shoichiro; Atsumi, Takashi

doi:10.1016/j.jse.2014.06.047

Cited by 48 publications

(63 citation statements)

References 32 publications

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“…10,26,38,39,46 For smaller lesions, excision of the lesion, open arthroscopic d ebridement, and chondroplasty, microfracture, or drilling techniques are required. 21,31,35,36,44 Many surgeons recommend internal fixation for larger lesions. 21,27,33 Because the stage of the OCD lesion will determine the type of treatment and is closely related to clinical outcome, staging systems with high interobserver agreement are essential.…”

Section: Discussionmentioning

confidence: 99%

Osteochondritis dissecans of the humeral capitellum: reliability of four classification systems using radiographs and computed tomography

Claessen

Ende

Doornberg

et al. 2015

Journal of Shoulder and Elbow Surgery

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Section: Discussionmentioning

confidence: 99%

Osteochondritis dissecans of the humeral capitellum: reliability of four classification systems using radiographs and computed tomography

Claessen

Ende

Doornberg

et al. 2015

Journal of Shoulder and Elbow Surgery

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“…All grafts reached osseous union by an average of 3.3 months. Four patients required reoperation for loose bodies or spur formation, but all four returned to their prior level of sport after reoperation [42]. COT is a valuable alternative for large (>15 mm) lesions involving the lateral column.…”

Section: Costal Osteochondral Transplantationmentioning

confidence: 91%

“…The procedure entails harvesting a costal osteochondral fragment with hyaline cartilage, usually from the sixth rib, for transplantation into the recipient site on the capitellum [5,42]. Zlotolow and Bae revealed that the costal hyaline cartilage layer is much thicker than in OATS grafts and must be trimmed in order to fit flush.…”

Section: Costal Osteochondral Transplantationmentioning

confidence: 99%

Osteochondritis dissecans of the elbow

Churchill

Muñoz

Ahmad

2016

Curr Rev Musculoskelet Med

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Capitellar osteochondritis dissecans (OCD) can be a significant problem in adolescent overhead athletes. The cause is likely multifactorial secondary to repetitive stresses, biomechanical mismatch, and a tenuous vascular supply of the capitellum. Recent literature reveals that the prevalence is likely higher than previously thought. This, in conjunction with increased levels of athletic competition in children at younger ages, has fed the recent interest in this topic. The literature continues to show that non-operative treatment is still successful for stable lesions. Unstable lesions, therefore, have been the focus of the new literature regarding operative management and outcomes. The aim of this paper is to provide a summary of current literature and an up-to-date approach to the diagnosis, evaluation, and treatment of osteochondritis dissecans of the capitellum.

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“…For unstable fragmented lesions, this typically includes debridement of the lesion, removal of loose bodies, and concomitant marrow stimulation with abrasion chondroplasty or microfracture [30•, 31-35]. Alternatively, several open and arthroscopic techniques exist for lesion repair with fragment [24] fixation as well as restorative procedures such as osteochondral autografting and allografting and cellularinduced cartilage scaffolds [36][37][38][39][40][41][42].…”

Section: Surgical Managementmentioning

confidence: 99%

“…When the OCD fragment is not salvageable, autograft osteochondral plugs can be taken from the knee [50][51][52] or harvested from either the fifth or sixth costal-osteochondral junction and implanted [41,53,54]. Most surgeons who perform capitellar OATS more commonly utilize the knee as a source for donor graft due to the familiarity of the anatomy and avoidance of complications associated with iatrogenic injury to the costal pleura.…”

Section: Arthroscopic Managementmentioning

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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Costal osteochondral autograft for reconstruction of advanced-stage osteochondritis dissecans of the capitellum

Cited by 48 publications

References 32 publications

Osteochondritis dissecans of the humeral capitellum: reliability of four classification systems using radiographs and computed tomography

Osteochondritis dissecans of the humeral capitellum: reliability of four classification systems using radiographs and computed tomography

Osteochondritis dissecans of the elbow

Elbow Injuries in the Adolescent Thrower

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