Abstract
Background:
Capitellar osteochondritis dissecans (OCD) is commonly encountered in youth athletes. There are limited reports on long term outcomes using validated outcome scores following surgical treatment of elbow OCD in adolescents.
Purpose:
To examine the outcomes of operative treatment of elbow OCD in adolescent athletes and investigate return to sport rate as well as athletic and daily function.
Methods:
17 adolescent athletes (average age 14.2 ± 1.5 years) and 18 elbows with OCD treated arthroscopically were retrospectively reviewed. The average duration of symptoms prior to surgery was 15.4 ± 12.5 months and average follow up was 4.4 ± 3.7 years. Data points examined included pre-operative lesion grade/size, range of motion (ROM), and bone age; intra-operative lesion grade/size; and post-operative ROM, Kerlan-Jobe Orthopaedic Clinic (KJOC) Overhead Athlete Shoulder and Elbow score, and Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score.
Results:
All patients were treated with initial diagnostic arthroscopy. 14/17 patients were definitively treated with arthroscopic debridement and marrow stimulation/microfracture. 3/17 patients required open treatment with two patients amendable to osteochondral fixation and one patient to open marrow stimulation/microfracture. 14/17 athletes returned to their sport post-operatively with 12/17 returning to the same level or higher, and 2/17 returning to a lower level of recreational play. 3/17 athletes did not return to sports but advised that this was by choice not due to their elbow OCD. Overall, there were significant improvements in elbow ROM post-operatively as well as excellent QuickDASH (average 1.9 ± 4.4) and KJOC scores (average 93 ± 8.0) seen amongst all athletes. There was no correlation between pre-operative lesion grade/size, bone age, or open versus arthroscopic treatment with outcome.
Conclusion:
Operative treatment of elbow OCD in adolescent athletes not only leads to high return to sports rates but also high levels of athletic and daily functional activity long term.