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. 2018 Dec 19;6(12):2325967118815846.
doi: 10.1177/2325967118815846. eCollection 2018 Dec.

Demographics and Epidemiology of Osteochondritis Dissecans of the Elbow Among Children and Adolescents

Jeffrey I Kessler  1 , John C Jacobs Jr  2 , Peter C Cannamela  3 , Jennifer M Weiss  1 , Kevin G Shea  4
Affiliations

Demographics and Epidemiology of Osteochondritis Dissecans of the Elbow Among Children and Adolescents

Jeffrey I Kessler et al. Orthop J Sports Med. .

Abstract

Background: Osteochondritis dissecans (OCD) of the elbow is a disorder of subchondral bone and articular cartilage, of which the incidence among children is not clearly known.

Purpose: To assess the demographics and epidemiology of OCD of the elbow among children.

Study design: Cross-sectional study; Level of evidence, 3.

Methods: A retrospective chart review of an integrated health system for the years 2007 through 2011 was performed for patients with elbow OCD aged 2 to 19 years. Lesion location, laterality, and all patient demographics were recorded. OCD incidence was determined for the group as a whole as well as by sex and age group (2-5, 6-11, 12-19 years). Patient differences based on age, sex, and ethnicity were analyzed, and multivariable logistic regression models were used to assess the risk of elbow OCD by group.

Results: A total of 37 patients with 40 OCD lesions fit the inclusion criteria. No lesion was found among 2- to 5-year-olds. A majority of lesions (n = 39, 97.5%) were in the capitellum, and 1 (2.5%) was in the trochlea. Twenty-five patients (67.6%) had right-sided lesions; 9 (24.3%), left-sided; and 3 (8.1%), bilateral. The incidence of elbow OCD for patients aged 6 to 19 years was 2.2 per 100,000 overall and 3.8 and 0.6 per 100,000 for males and females, respectively. The majority of OCD cases were seen in those aged 12 to 19 years, with an incidence of 3.4 per 100,000 versus 0.38 among 6- to 11-year-olds. Multivariable logistic regression analysis revealed a 21.7-times increased odds ratio of elbow OCD among patients aged 12 to 19 years versus 6 to 11 years, and males had a 6.8-times greater odds ratio of elbow OCD than females (P < .0001 for both). Based on race and ethnicity, non-Hispanic whites had the highest incidence of elbow OCD as compared with all other ethnic groups.

Conclusion: In this population-based cohort study of pediatric elbow OCD, males had almost 7 times the risk of elbow OCD as compared with females, and 12- to 19-year-olds had nearly 22 times the risk of elbow OCD versus 6- to 11-year-olds. In keeping with many prior studies, the majority of patients had right-sided lesions.

Keywords: OCD; elbow; epidemiology; osteochondritis dissecans; pediatric.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: J.I.K., J.M.W., and K.G.S. are members of the ROCK (Research in OsteoChondritis of the Knee) research group, which receives unrestricted educational grants from Allosource of Vericel. K.G.S. has received grants from DePuy Orthopaedics and Sanofi-Aventis and hospitality payments from DePuy Orthopaedics. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

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