Osteochondral Autograft Transplantation for Osteochondritis Dissecans of the Elbow in Juvenile Baseball Players: Minimum 2-Year Follow-up

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Abstract

Background

Osteochondral autografts have recently become popular to treat articular cartilage defects, and they are used for unstable osteochondritis dissecans lesions as a means of biological fixation.

Purpose

To evaluate the clinical results of osteochondral autograft transfer for osteochondritis dissecans of the elbow.

Study Design

Case series; Level of evidence, 4.

Methods

Osteochondral autograft transfer was performed on 18 baseball players (mean age, 13.6 years) with osteochondritis dissecans of the elbow. These included 9 lesions that were grade 3 (separated but in situ) and 9 lesions that were grade 4 (displaced fragment with osteochondral defect) based on magnetic resonance imaging. All patients were evaluated with a scoring system, radiographs, and magnetic resonance imaging, with the mean follow-up at 3.5 years.

Results

In patients with grade 3 lesions, the subjective score was increased, but the objective score did not change. Six of 9 patients returned to their previous sports performance levels. One quit baseball because of academic reasons, 1 changed his position, and 1 changed to softball. In patients with grade 4 lesions, both subjective and objective scores were increased significantly. All but 1 patient returned to their previous sports performance levels. In the 3 grade 4 lesions with a wide osteochondral defect, the irregularity of the articular surface remained on magnetic resonance imaging.

Conclusion

Osteochondral autograft transplantation is a useful treatment for reattachment of the lesion as well as osteochondral resurfacing of elbow osteochondritis dissecans.

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