Osteochondral autograft plug transfer for treatment of osteochondritis dissecans of the capitellum in adolescent athletes

Lyons, Matthew; Werner, Brian C.; Gluck, Joshua S.; Freilich, Aaron M.; Dacus, A. Rashard; Diduch, David R.; Chhabra, Arvind

doi:10.1016/j.jse.2015.03.014

Cited by 68 publications

(46 citation statements)

References 28 publications

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“…The three common abnormalities of ED are fragmented medial coronoid process (FCP), osteochondritis dissecans (OCD) of the medial humeral condyle, and ununited anconeal process (UAP). Adolescent children can develop OCD in the elbow [12]. In Labrador Retrievers, heritability of elbow OA secondary to either OCD or FCP was estimated at 0.27 [13, 14].…”

Section: Introductionmentioning

confidence: 99%

A novel iterative mixed model to remap three complex orthopedic traits in dogs

et al. 2017

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Hip dysplasia (HD), elbow dysplasia (ED), and rupture of the cranial (anterior) cruciate ligament (RCCL) are the most common complex orthopedic traits of dogs and all result in debilitating osteoarthritis. We reanalyzed previously reported data: the Norberg angle (a quantitative measure of HD) in 921 dogs, ED in 113 cases and 633 controls, and RCCL in 271 cases and 399 controls and their genotypes at ~185,000 single nucleotide polymorphisms. A novel fixed and random model with a circulating probability unification (FarmCPU) function, with marker-based principal components and a kinship matrix to correct for population stratification, was used. A Bonferroni correction at p<0.01 resulted in a P< 6.96 ×10−8. Six loci were identified; three for HD and three for RCCL. An associated locus at CFA28:34,369,342 for HD was described previously in the same dogs using a conventional mixed model. No loci were identified for RCCL in the previous report but the two loci for ED in the previous report did not reach genome-wide significance using the FarmCPU model. These results were supported by simulation which demonstrated that the FarmCPU held no power advantage over the linear mixed model for the ED sample but provided additional power for the HD and RCCL samples. Candidate genes for HD and RCCL are discussed. When using FarmCPU software, we recommend a resampling test, that a positive control be used to determine the optimum pseudo quantitative trait nucleotide-based covariate structure of the model, and a negative control be used consisting of permutation testing and the identical resampling test as for the non-permuted phenotypes.

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Section: Introductionmentioning

confidence: 99%

A novel iterative mixed model to remap three complex orthopedic traits in dogs

et al. 2017

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“…Despite 6 of 8 patients returning to competitive baseball and 7 of 8 being completely pain free at 24 months, 5 patients had persistent knee effusions at a mean of 5 weeks. 16 Lyons et al 18 have recently published on 11 patients who underwent an autologous osteochondral transfer harvested from the ipsilateral knee. They concluded that treatment of large, unstable OCD lesions of the capitellum by autologous transfer from the knee in adolescent athletes is safe, allows reliable return to play, and has good clinical outcomes at short-term follow-up.…”

Section: Discussionmentioning

confidence: 99%

Fresh Osteochondral Allograft Transplantation for the Treatment of Unstable Osteochondritis Dissecans of the Capitellum in the Elbow

Singh

Mirzayan

2016

Techniques in Shoulder &Amp; Elbow Surgery

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Several surgical treatments have been reported in the literature for the treatment of osteochondritis dissecans of the humeral capitellum, including arthroscopic debridement, microfracture, and transhumeral drilling; none of which restore a hyaline articular cartilage surface and are asssociated with poor return to sport. Osteochondral autograft transfer from the patient's own knee or rib has also been described, which restores hyaline articular surfaces and has better outcomes, but may lead to donor site morbidity. We describe our ligament-sparing technique and clinical experience with the transplantation of fresh osteochondral allograft to treat unstable osteochondritis dissecans of the capitellum, namely in overhead athletes.

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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%

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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Osteochondral autograft plug transfer for treatment of osteochondritis dissecans of the capitellum in adolescent athletes

Cited by 68 publications

References 28 publications

A novel iterative mixed model to remap three complex orthopedic traits in dogs

A novel iterative mixed model to remap three complex orthopedic traits in dogs

Fresh Osteochondral Allograft Transplantation for the Treatment of Unstable Osteochondritis Dissecans of the Capitellum in the Elbow

Elbow Injuries in the Adolescent Thrower

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