Cylindrical Costal Osteochondral Autograft for Reconstruction of Large Defects of the Capitellum Due to Osteochondritis Dissecans

Abstract

Cylindrical costal osteochondral autograft was useful for the treatment of advanced osteochondritis dissecans of the humeral capitellum. Functional recovery was rapid after surgery. Additional operations were performed for five of the twenty-six patients, whereas the remaining patients showed essentially full recovery within a year. All patients were satisfied with the results at the time of short-term follow-up.

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

“…20 Shimada et al reported that although 5 of 26 patients required repeated surgery, progress after the second surgery was good. 25 We described only a few short-term outcomes in which all of our patients were able to pitch a baseball within 4 months of the surgery and were able to return to sports after 7.5 months. However, 4 patients required additional surgery during follow-up.…”

“…The 5 patients of Shimada et al who required repeated surgery and our own experiences were consistent in that the 3 patients with movement limitations due to free bodies and osteophytes were able to return to competitive sports after repeated surgery. 25 Screw displacement and separation of the cartilage fragments that we experienced occurred in patients in whom the costal cartilage portion became completely separated from the costal bone during surgery. Hasegawa et al described the importance of nutrient supply from the bone to the cartilage and that when this is closed, it causes chondronecrosis.…”

“…18 Although there have been only a few reports on large numbers of cases, all have described very good outcomes. 14,[22][23][24][25] We describe the postoperative outcomes of patients who were observed for up to 6 years and 5 months after undergoing costal osteochondral autograft transplantation.…”

Midterm clinical results of osteochondral autograft transplantation for advanced stage Freiberg disease

“…OAT is one of the established procedures for limited size osteochondral lesions in the knee, ankle and elbow joints. Application of this technique for hip lesions has recently been reported [14][15][16][17][18][19][20][21].…”

Topographic Analysis of the Capitellum and Distal Femoral Condyle: Finding the Best Match for Treating Osteochondral Defects of the Humeral Capitellum

“…[3][4][5] OATS has been proposed to treat lesions that involve 50% of the articular surface or more. The donor plugs are pressfitted into the lesion to restore the surface topography and to provide subchondral replacement in the defect.…”