Osteochondritis Dissecans of the capitellum of the elbow: improved outcomes in surgically treated versus nonoperatively treated patients at long-term follow-up

Review written by Dr Val Jones info

Key Points

  1. Osteochondral defects occur in adolescent athletes and can have serious implications on participation in future sporting participation.
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BACKGROUND & OBJECTIVE

Osteochondral defects (OCD) in the elbow are most commonly seen in adolescent athletes, such as gymnasts, throwers, weightlifters and swimmers. They are usually seen in the capitellum (1), and the cause is thought to be repetitive loading, resulting in subchondral stress fractures. Symptoms of OCD include lateral elbow pain, stiffness and other mechanical symptoms, and the diagnosis is confirmed through imaging. Early detection and treatment of this condition may prevent progression of the defect. Lesions are usually graded based on the criteria described by Takahara et al (2) ranging from grade IA to grade IIB (most severe).

The aims of this paper were:

  • to report on the outcomes of treatment for this condition, including conservative and surgical management.

  • to identify factors contributing to poor outcome with conservative treatment

  • to determine whether delays in surgery are detrimental to outcome.

Osteochondral defects (OCD) are usually seen in the capitellum, and the cause is thought to be repetitive loading, resulting in subchondral stress fractures.
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CT scans are the best modality to detect loose bodies within the joint, and these loose bodies may need to be surgically removed as they are a predictor of poor conservative outcome.

METHODS

  • This was a retrospective cohort review of all individuals diagnosed with capitellar OCD, at a specialist surgical center over a 20-year period, with a minimum of 12 months follow up.
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