Osteochondral autograft transplantation for osteochondritis dissecans of the elbow in juvenile baseball players: minimum 2-year follow-up

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.