Outcomes of an Open Autologous Osteochondral Plug Graft for Capitellar Osteochondritis Dissecans

Maruyama, Masahiro; Takahara, Masatoshi; Harada, Mikio; Satake, Hiroshi; Takagi, Michiaki

doi:10.1177/0363546514538759

Cited by 74 publications

(82 citation statements)

References 22 publications

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“…Surgery is indicated for patients who fail non-operative treatment and those with unstable lesions [6]. The surgical treatments are variable, including debridement, drilling or micro-fracture, fragment fixation, and osteochondral autograft transplantation [1,[7][8][9][10]. Among them, the debridement with fragment fixation is a time-tested procedure and one of the most widely used methods for surgical treatment of unstable capitellum OCD [11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Is there any difference between open and arthroscopic treatment for osteochondritis dissecans (OCD) of the humeral capitellum: a systematic review and meta-analysis

Guo

et al. 2018

International Orthopaedics (SICOT)

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Purpose We present a systematic review of the recent literatures regarding the arthroscopic and open technique in fragment fixation for osteochondritis dissecans (OCD) of the humeral capitellum and an analysis of the subjective and objective outcomes between these two procedures. Methods PubMed and EMBASE were reviewed for suitable articles relating to fragment fixation for OCD, both open and arthroscopic. We included all studies reporting on the clinical outcomes of these two procedures that were published in the English language. Data extracted from each study included level of evidence, number of patients, surgical techniques, length of follow-up, clinical outcome measures including outcome scores, range of motion (ROM), return to sports, osseous union and complications. We analyzed each study to determine the primary outcome measurement.

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Section: Introductionmentioning

confidence: 99%

Is there any difference between open and arthroscopic treatment for osteochondritis dissecans (OCD) of the humeral capitellum: a systematic review and meta-analysis

Guo

et al. 2018

International Orthopaedics (SICOT)

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“…5 In studies of osteochondral plug grafting for OCD grade III and IV lesions, the mean TimmermanAndrews score has been reported to improve significantly: from 150 to 180 with 77% of patients able to resume their former level of sport, 10 from 131 to 191 with 90% of patients able to resume their former level of sport, 11 and from 130 to 190 with 91% of patients able to resume their competitive level after a mean of 6.9 months. 12 In our study, the score improved from 163 to 189 with 70% of patients able to resume sport at a competitive level. Therefore, the results of bonepeg grafting for OCD grade II lesions are inferior to those of osteochondral plug grafting for grade III and IV lesions.…”

Section: Discussionmentioning

confidence: 45%

Bone-Peg Grafting for Osteochondritis Dissecans of the Humeral Capitellum

Maruyama

Harada

Satake

et al. 2016

J Orthop Surg (Hong Kong)

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Purpose. To review the outcome of bone-peg grafting for osteochondritis dissecans (OCD) grade II lesions of the humeral capitellum. Methods. Records of 10 male adolescent baseball players aged 10 to 15 (mean, 12.3) years who underwent bone-peg grafting for OCD grade II lesions of the humeral capitellum of the dominant arm were reviewed. The mean time from symptom onset to presentation was 11 (range, 1-36) months. The mean duration of conservative treatment was 5 (range, 1-25) months. The mean time from symptom onset to surgery was 17 (range, 3-39) months; it was >6 months in 6 patients. The mean size of the lesions was 13x14 mm. Patients were assessed for elbow pain, range of elbow and forearm motion, TimmermanAndrews elbow score, return to sports activity level, and radiographic evidence of healing, osteoarthritic changes, and radial head hypertrophy. Results. The mean follow-up period was 25 (range, 10-52) months. Postoperatively, elbow pain was absent in 6, mild in 2, and moderate in 2 patients. The mean range of elbow motion changed from 136º to 139° (p=0.80). The mean Timmerman-Andrews elbow score improved from 163 to 189 (p=0.014); it was excellent in 7, good in 2, and fair in one Bone-peg grafting for osteochondritis dissecans of the humeral capitellum

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“…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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Outcomes of an Open Autologous Osteochondral Plug Graft for Capitellar Osteochondritis Dissecans

Abstract: The results of this study indicate that an open autologous osteochondral plug graft allows a return to the previous competitive level of throwing by a mean of 7 months postoperatively.

Cited by 74 publications

References 22 publications

Is there any difference between open and arthroscopic treatment for osteochondritis dissecans (OCD) of the humeral capitellum: a systematic review and meta-analysis

Is there any difference between open and arthroscopic treatment for osteochondritis dissecans (OCD) of the humeral capitellum: a systematic review and meta-analysis

Bone-Peg Grafting for Osteochondritis Dissecans of the Humeral Capitellum

Elbow Injuries in the Adolescent Thrower

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