Bradley Schoch1, Brian R Wolf. 1. Department of Orthopaedics and Rehabilitation, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, U.S.A.
Abstract
PURPOSE: The purpose of our study is to show that arthroscopic debridement is an appropriate intervention for midterm to long-term subjective symptom relief of osteochondritis dissecans (OCD) of the elbow. METHODS: A retrospective case series of 13 patients undergoing arthroscopic treatment of OCD of the elbow over a 10-year period was studied. Patients were assessed with a mean follow-up of 3.6 years (range, 12 months to 8 years). The disability/symptom section of the Disabilities of the Arm, Shoulder and Hand (DASH) was used to measure patient-reported outcome. Additional questions were used to assess other injuries to the elbow and return to sports activities. RESULTS: Of 13 patients, 8 reported participating in repetitive valgus stress sports associated with overhead throwing. Two participated in gymnastics. Ten patients provided follow-up data greater than 1 year after surgical intervention. The mean follow-up DASH score for surgically treated patients was 8.6 (range, 0.0 to 22.41). Four patients reported a complete return to their sports activities, and six reported complete cessation of at least 1 sport. By use of intraoperative reports, the OCD lesions were graded according to the Classification System for OCD Lesions established by the American Sports Medicine Institute. No difference in mean DASH score between grades was found. CONCLUSIONS: In our small group of patients, arthroscopic debridement of OCD of the capitellum resulted in a functional elbow with subjective symptom relief for the majority of patients, as evidenced by DASH scores. However, despite a functional outcome, many patients reported ceasing at least some sporting activities because of their elbow. LEVEL OF EVIDENCE: Level IV, therapeutic case series. Published by Elsevier Inc.
PURPOSE: The purpose of our study is to show that arthroscopic debridement is an appropriate intervention for midterm to long-term subjective symptom relief of osteochondritis dissecans (OCD) of the elbow. METHODS: A retrospective case series of 13 patients undergoing arthroscopic treatment of OCD of the elbow over a 10-year period was studied. Patients were assessed with a mean follow-up of 3.6 years (range, 12 months to 8 years). The disability/symptom section of the Disabilities of the Arm, Shoulder and Hand (DASH) was used to measure patient-reported outcome. Additional questions were used to assess other injuries to the elbow and return to sports activities. RESULTS: Of 13 patients, 8 reported participating in repetitive valgus stress sports associated with overhead throwing. Two participated in gymnastics. Ten patients provided follow-up data greater than 1 year after surgical intervention. The mean follow-up DASH score for surgically treated patients was 8.6 (range, 0.0 to 22.41). Four patients reported a complete return to their sports activities, and six reported complete cessation of at least 1 sport. By use of intraoperative reports, the OCD lesions were graded according to the Classification System for OCD Lesions established by the American Sports Medicine Institute. No difference in mean DASH score between grades was found. CONCLUSIONS: In our small group of patients, arthroscopic debridement of OCD of the capitellum resulted in a functional elbow with subjective symptom relief for the majority of patients, as evidenced by DASH scores. However, despite a functional outcome, many patients reported ceasing at least some sporting activities because of their elbow. LEVEL OF EVIDENCE: Level IV, therapeutic case series. Published by Elsevier Inc.
Authors: Robert W Westermann; Kyle J Hancock; Joseph A Buckwalter; Benjamin Kopp; Natalie Glass; Brian R Wolf Journal: Orthop J Sports Med Date: 2016-06-28