Osteochondral autograft plug transfer for treatment of osteochondritis dissecans of the capitellum in adolescent athletes
| Autor: | Aaron M. Freilich, Matthew L. Lyons, Brian C. Werner, A. Bobby Chhabra, A. Rashard Dacus, David R. Diduch, Joshua S. Gluck |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Cumulative Trauma Disorders Radiography Adolescent athletes Elbow Transplantation Autologous Arthroscopy Dash Elbow Joint Medicine Humans Orthopedics and Sports Medicine Retrospective Studies Bone Transplantation business.industry General Medicine Humerus medicine.disease Osteochondritis dissecans Osteochondritis Dissecans Return to play Confidence interval Surgery Return to Sport medicine.anatomical_structure Cartilage Treatment Outcome Athletic Injuries Physical therapy Female business Range of motion Elbow Injuries |
| Zdroj: | Journal of shoulder and elbow surgery. 24(7) |
| ISSN: | 1532-6500 |
| Popis: | Background Osteochondritis dissecans (OCD) of the capitellum is a condition most commonly seen in adolescents involved in repetitive overhead sports and can profoundly affect ability to return to play and long-term elbow function. Treatment of large, unstable defects in the elbow with osteochondral autograft plug transfer has not been adequately studied. Methods We retrospectively identified 11 teenaged patients with large (>1 cm 2 ) capitellar OCD treated with osteochondral autograft plug transfer. Average age at the time of surgery was 14.5 years (range, 13-17 years). Outcome measures obtained included return to play, preoperative and postoperative elbow range of motion, Disabilities of Arm, Shoulder and Hand (DASH; Institute for Work and Health, Toronto, ON, Canada) by telephone interview, and osseous integration on radiographs. All 11 patients were available for evaluation at an average of 22.7 months (range, 6-49 months) postoperatively. Results All patients were involved in competitive high school athletics and returned to at least their preinjury level of play. Average return to play was 4.4 months (range 3-7 months). The average final DASH was 1.4 (95% confidence interval, 0.6-2.1), and the average final sport-specific DASH was 1.7 (95% confidence interval −1.8 to 5.2). Elbow range of motion significantly improved, including improvement in flexion from a preoperative average of 126° to a postoperative average of 141° ( P = .009) and improvement in extension from a preoperative average of 21° to a postoperative average of 5° ( P = .006). Conclusions Treatment of large, unstable OCD lesions of the capitellum in adolescent athletes allows reliable return to play, is safe, and has good clinical outcomes at short-term follow-up. |
| Databáze: | OpenAIRE |
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