Yi Lu1, Yi Jun Li2, Si Yi Guo2, Hai Long Zhang2. 1. Sports Medicine Service, Beijing Jishuitan Hospital, No.31, Xin Jie Kou Dong Jie Street, Xi Cheng District, Beijing, China. luyi_orthop@hotmail.com. 2. Sports Medicine Service, Beijing Jishuitan Hospital, No.31, Xin Jie Kou Dong Jie Street, Xi Cheng District, Beijing, China.
Abstract
PURPOSE: We present a systematic review of the recent literatures regarding the arthroscopic and open technique in fragment fixation for osteochondritis dissecans (OCD) of the humeral capitellum and an analysis of the subjective and objective outcomes between these two procedures. METHODS: PubMed and EMBASE were reviewed for suitable articles relating to fragment fixation for OCD, both open and arthroscopic. We included all studies reporting on the clinical outcomes of these two procedures that were published in the English language. Data extracted from each study included level of evidence, number of patients, surgical techniques, length of follow-up, clinical outcome measures including outcome scores, range of motion (ROM), return to sports, osseous union and complications. We analyzed each study to determine the primary outcome measurement. RESULTS: A total of ten studies met our inclusion criteria. Among all studies, 35 arthroscopic procedures and 107 open procedures were performed. After the procedure, 70 patients (86.4%) in the open group returned to their sports, and 32 patients (91.4%) in the arthroscopic group returned to their sports. In the arthroscopic group, patients gained 14.1 degrees of flexion and 9.5 degrees of extension after surgery. In the open group, patients gained 8 degrees of flexion and 5.7 degrees of extension. Five patients (4.7%) had complications in the open group. No complication was found in the arthroscopic group. CONCLUSIONS: Both open and arthroscopic lesion debridement with fragment fixation are successful in treating unstable OCD. The arthroscopic technique may be a better choice than the open procedure, but we need high-level evidence to determine the superiority of the open or arthroscopic techniques in treating elbow OCD. LEVEL OF EVIDENCE: Level III.
PURPOSE: We present a systematic review of the recent literatures regarding the arthroscopic and open technique in fragment fixation for osteochondritis dissecans (OCD) of the humeral capitellum and an analysis of the subjective and objective outcomes between these two procedures. METHODS: PubMed and EMBASE were reviewed for suitable articles relating to fragment fixation for OCD, both open and arthroscopic. We included all studies reporting on the clinical outcomes of these two procedures that were published in the English language. Data extracted from each study included level of evidence, number of patients, surgical techniques, length of follow-up, clinical outcome measures including outcome scores, range of motion (ROM), return to sports, osseous union and complications. We analyzed each study to determine the primary outcome measurement. RESULTS: A total of ten studies met our inclusion criteria. Among all studies, 35 arthroscopic procedures and 107 open procedures were performed. After the procedure, 70 patients (86.4%) in the open group returned to their sports, and 32 patients (91.4%) in the arthroscopic group returned to their sports. In the arthroscopic group, patients gained 14.1 degrees of flexion and 9.5 degrees of extension after surgery. In the open group, patients gained 8 degrees of flexion and 5.7 degrees of extension. Five patients (4.7%) had complications in the open group. No complication was found in the arthroscopic group. CONCLUSIONS: Both open and arthroscopic lesion debridement with fragment fixation are successful in treating unstable OCD. The arthroscopic technique may be a better choice than the open procedure, but we need high-level evidence to determine the superiority of the open or arthroscopic techniques in treating elbow OCD. LEVEL OF EVIDENCE: Level III.
Entities:
Keywords:
Arthroscopy; Fragment fixation; Humeral capitellum; Open; Osteochondritis dissecans
Authors: William P Hennrikus; Patricia E Miller; Lyle J Micheli; Peter M Waters; Donald S Bae Journal: J Pediatr Orthop Date: 2015 Jul-Aug Impact factor: 2.324
Authors: Richard J McLaughlin; Devin P Leland; Christopher D Bernard; Joaquin Sanchez-Sotelo; Mark E Morrey; Shawn W O'Driscoll; Christopher L Camp Journal: Arthrosc Sports Med Rehabil Date: 2021-03-16