Outcomes of surgical treatment for osteochondritis dissecans of the elbow: evaluation by lesion location

Yamagami, Nobuo; Yamamoto, Sachiko; Aoki, Akira; Ito, Shoko; Uchio, Yuji

doi:10.1016/j.jse.2018.08.011

Cited by 18 publications

(13 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…6 On the other hand, some OCD lesions that are expanding to the lateral capitellar wall will probably become "too big to treat" with "autologous elbow-to-elbow" OATS. 7 The current findings mean that we have a basis to proceed with in vivo studies to refine the surgical techniques and instrumentation with caution.…”

Section: See Related Article On Page 3025mentioning

confidence: 87%

Editorial Commentary: “Elbow-to-Elbow” Capitellar Osteochondral Autologous Transplantation for Osteochondritis Dissecans—Are We Closer to the Holy Grail of Osteochondral Graft?

Kholinne

Koh

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

View full text Add to dashboard Cite

Section: See Related Article On Page 3025mentioning

confidence: 87%

Editorial Commentary: “Elbow-to-Elbow” Capitellar Osteochondral Autologous Transplantation for Osteochondritis Dissecans—Are We Closer to the Holy Grail of Osteochondral Graft?

Kholinne

Koh

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

View full text Add to dashboard Cite

“…As a consequence of the findings described above, many authors tend to replace the subchondral, malvascularized bone in advanced OCD stages (e.g. grades III to IV) using osteochondral bone grafts [ 16 , 17 , 36 , 37 ]. This can provide additional healthy hyaline cartilage as new joint surface tissue, either transplated as a single bone plug or mosaicplasty.…”

Section: Discussionmentioning

confidence: 99%

“…Oshiba et al, who used multiple bone plugs for mainly early lesions (ICRS grade I and II; Minami stage I and II) reported complete radiological healing in 8 of 11 cases; however, healing needed up to 24 months to become evident in MRI [ 16 ]. Another study has, however, shown that large-size defects, which span from the lateral to the central articular portion, may not heal as well as central lesions after OAG transplantation [ 36 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

Treatment of advanced stage osteochondrosis dissecans in the adolescent elbow using a hyaloronic acid-based scaffold: a case series of 5 patients

Farr

Pallamar

Eder

et al. 2021

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

Introduction Osteochondrosis dissecans (OCD) is considered to be one of the main causes for pain, discomfort and morbidity in the pediatric elbow joint. Few treatment options, such as microfracture or autologous transplantation, of osteochondral bone grafts have been described to address advanced OCD. The aim of this retrospective case series is to present preliminary clinical and radiologic findings following advanced stage OCD repair using a novel combination of a hyaluronic acid-based scaffold with autologous iliac crest bone grafting. Materials and methods Five adolescents, who underwent treatment of OCD (grade 3 or 4 according to Nelson) using a combination technique of defect debridement, transplantation of cancellous iliac crest bone and application of a HYALOFAST® membrane (Anika Therapeutics S.r.L., Italy), were re-assessed using clinical and radiologic examinations (defect diameter, depth, sclerosis, congruency, fragmentation, dissection, radiolucency, growth plate status; MRI) after a minimum of 2 years (mean, 34 months; range, 24–45) postoperatively. Dedicated outcome scores (Numeric Rating Scale [NRS], Pediatric Outcome Data Collection Instrument [PODCI], Mayo Elbow Performance Score [MEPS], and Timmerman-Andrews Score [TIMM] were collected. Results All patients reported a NRS score of 0. The mean total TIMM, MEPS and PODCI (Global Functioning Scale) scores were 189 (range 165–200), 94 (range, 70–100), and 92 (range 83–98; normative score 47; range 35–55), respectively, indicating good to excellent clinical outcomes. The radiographic analysis showed overall improvements with regard to OCD width and depth reduction (35%, − 27–100%; 52%, 4–100%), but full resolution in only 2 of 5 cases. Elbow motion improved slightly after surgery. No complications were noted. Conclusion This study showed promising clinical short- to mid-term results in adolescent patients with advanced OCD using a novel surgical treatment combination. Radiographic results showed partial healing; hence, residual changes should be monitored over a longer period.

show abstract

“…ROM of the elbow and the Japanese Orthopaedic Association–Japan Elbow Society Elbow Function Score (JOA-JES score) were measured before surgery and at final follow-up, and the preoperative and final values for each were compared by paired t test. 12,17 The time to return to sports and the rates of recurrence and complications were also investigated. In all analyses, P < .05 was defined as statistically significant.…”

Section: Methodsmentioning

confidence: 99%

Early Clinical Results of Arthroscopically Assisted Drilling via the Radius in a Distal-to-Proximal Direction for Osteochondritis Dissecans of the Elbow

Hara

Inoue

Minami

et al. 2019

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background: We have previously reported the technique of arthroscopically assisted drilling of osteochondritis dissecans (OCD) lesions of the elbow via the radius in a distal-to-proximal direction. With this technique, the entire OCD lesion can be drilled vertically under arthroscopic guidance with pronation and supination of the forearm and flexion and extension of the elbow joint. Purpose: To retrospectively evaluate return to sport, range of motion, and the Japanese Orthopaedic Association–Japan Elbow Society Elbow Function Score (JOA-JES score) after treatment of an elbow OCD lesion by drilling through the radius. Study Design: Case series; Level of evidence, 4. Methods: From November 2003 to January 2006, a total of 7 male adolescent baseball players with OCD lesions of the elbow were treated through use of arthroscopically assisted drilling via the radius. The stage of the OCD lesion was evaluated based on preoperative plain radiographs. Patients were observed for a minimum of 36 months, and clinical analysis included time for return to sport, elbow range of motion, and the JOA-JES score before intervention and at final follow-up. Results: We evaluated all 7 patients at a mean follow-up time of 36.1 months (range, 24-68 months). The stage of the OCD lesion on plain radiography was “translucent” in 1 patient, “sclerotic” in 5 patients, and “loosening” in 1 patient. The mean range of motion before surgery was 131.2° and –4.7° in flexion and extension, respectively, and this improved to 138.6° and 1.1° at final follow-up. The improvement in extension was statistically significant ( P = .04). The mean JOA-JES score of 83.0 before surgery significantly improved to 94.0 at final follow-up ( P < .001). One patient required excision of a free body at 51 months postoperatively, but all patients returned to sports early and without pain at an average of 4.6 months postoperatively. No feature of osteoarthrosis was noted on radiography on the final examination in any patient. Conclusion: The findings of this study demonstrate that arthroscopically assisted drilling of an elbow OCD lesion through the radial head allows for early return to sporting activities as well as improved motion and functional scores.

show abstract

Outcomes of surgical treatment for osteochondritis dissecans of the elbow: evaluation by lesion location

Cited by 18 publications

References 19 publications

Editorial Commentary: “Elbow-to-Elbow” Capitellar Osteochondral Autologous Transplantation for Osteochondritis Dissecans—Are We Closer to the Holy Grail of Osteochondral Graft?

Editorial Commentary: “Elbow-to-Elbow” Capitellar Osteochondral Autologous Transplantation for Osteochondritis Dissecans—Are We Closer to the Holy Grail of Osteochondral Graft?

Treatment of advanced stage osteochondrosis dissecans in the adolescent elbow using a hyaloronic acid-based scaffold: a case series of 5 patients

Early Clinical Results of Arthroscopically Assisted Drilling via the Radius in a Distal-to-Proximal Direction for Osteochondritis Dissecans of the Elbow

Contact Info

Product

Resources

About