PURPOSE OF THE STUDY: We present the cases of six adolescents (four high-level gymnastics specialists) with osteochondritis dissecans of the capitulum who were treated with an en bloc osteochondral autograft. There are few series of this rare condition reported in the literature. MATERIAL AND METHODS: All six patients presented pain over the lateral aspect of the elbow and limited extension; pronosupination was unaffected. Physical examination and plain X-rays enabled the diagnosis of osteochondritis dissecans. Postoperative X-rays confirmed good integration of the bone graft. These patients underwent lateral arthrotomy for curettage and avivement followed by an en bloc grafting. The graft was harvested from the homolateral knee via minimal arthrotomy, from a non-weight-bearing zone of the lateral condyle. RESULTS: At three months, complete pain-free range of motion was achieved in four of six patients. Graft integration was confirmed in all six patients on the three months plain X-rays, arthro-CT, or MRI. The four gymnastic specialists resumed their high-level sports activities at one year (at six months for one of them). DISCUSSION: Various surgical methods have been proposed. Series reported in the literature, like ours, have been small, with short follow-up. We have observed good results with an en bloc graft, encouraging us to continue with this surgical strategy.
PURPOSE OF THE STUDY: We present the cases of six adolescents (four high-level gymnastics specialists) with osteochondritis dissecans of the capitulum who were treated with an en bloc osteochondral autograft. There are few series of this rare condition reported in the literature. MATERIAL AND METHODS: All six patients presented pain over the lateral aspect of the elbow and limited extension; pronosupination was unaffected. Physical examination and plain X-rays enabled the diagnosis of osteochondritis dissecans. Postoperative X-rays confirmed good integration of the bone graft. These patients underwent lateral arthrotomy for curettage and avivement followed by an en bloc grafting. The graft was harvested from the homolateral knee via minimal arthrotomy, from a non-weight-bearing zone of the lateral condyle. RESULTS: At three months, complete pain-free range of motion was achieved in four of six patients. Graft integration was confirmed in all six patients on the three months plain X-rays, arthro-CT, or MRI. The four gymnastic specialists resumed their high-level sports activities at one year (at six months for one of them). DISCUSSION: Various surgical methods have been proposed. Series reported in the literature, like ours, have been small, with short follow-up. We have observed good results with an en bloc graft, encouraging us to continue with this surgical strategy.