Outcomes of surgical treatment for osteochondritis dissecans of the elbow: evaluation by lesion location
| Autor: | Soichiro Yamamoto, Yuji Uchio, Akira Aoki, Shuji Ito, Nobuo Yamagami |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Adolescent Radiography Elbow behavioral disciplines and activities Lesion Cohort Studies 03 medical and health sciences 0302 clinical medicine mental disorders Elbow Joint medicine Humans Orthopedics and Sports Medicine Femur Range of Motion Articular Surgical treatment Autografts Child Fixation (histology) Retrospective Studies 030222 orthopedics business.industry 030229 sport sciences General Medicine medicine.disease Osteochondritis dissecans Osteochondritis Dissecans Surgery Return to Sport Transplantation medicine.anatomical_structure Cartilage medicine.symptom business Range of motion |
| Zdroj: | Journal of shoulder and elbow surgery. 27(12) |
| ISSN: | 1532-6500 |
| Popis: | Background For treatment of advanced elbow osteochondritis dissecans (OCD), we have used surgical treatment. Although favorable treatment outcomes have been reported for centrally located OCD, treatment outcomes are generally questionable and the choice of surgical method is controversial for laterally located OCD. Our purpose was to evaluate the treatment outcomes based on lesion location. Methods The patients were 30 young (mean age, 14 years) male athletes who underwent surgical treatment of elbow OCD and were monitored for more than 1 year. Osteochondral autografts harvested from the knee were transplanted to centralized (13 patients) or lateral localized (9 patients) OCD lesions. For lateral widespread (8 patients) OCD lesions, a detached osteochondral fragment was fixed using small osteochondral plugs. When the remaining cartilage defect was large after fragment fixation, a large-sized osteochondral plug was transplanted to the defect. Treatment outcomes were evaluated by the Japanese Orthopaedic Association score, elbow range of motion (ROM), and radiographic findings. Results The Japanese Orthopaedic Association score significantly improved in patients with centralized, lateral localized, and lateral widespread types of OCD. ROM significantly improved in patients with centralized and lateral localized, and they returned to playing sports within 6 months. However, patients with lateral widespread OCD exhibited no significant ROM improvement, and returning to sports was difficult for 3 patients because of poor osseous integration of the fixed osteochondral fragment. Conclusions Osteochondral autograft transplantation provided favorable outcomes for centralized and lateral localized elbow OCD lesions. However, for lateral widespread OCD lesions, reconstruction of the entire capitellar lesion area may be necessary. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect