Fixation of osteochondritis dissecans lesions produces good outcomes in young athletes

SEATTLE — A study presented at the American Orthopaedic Society for Sports Medicine demonstrated positive long-term outcomes for young athletes with osteochondritis dissecans lesions.

Researchers identified 11 patients unable to participate in competitive sports due to osteochondritis dissecans lesions of the capitellum. Patients underwent loose body removal, lateral collateral ligament takedown from lateral epicondyle and plus transfer from the lateral trochlear ridge of the ipsilateral knee. All patients were then immobilized in a splint for 2 weeks, converted to a hinged elbow brace with progressive range of motion for 4 weeks, then resumed throwing and strengthening exercises at 3 months postoperatively. Metrics evaluated included chart review, return-to-play, elbow range of motion and DASH outcomes. Mean follow-up was 22.7 months.

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All athletes returned to at least preoperative level of play at an average of 4.4 months, three of whom have received Division 1 college scholarships. Of the five pitchers, four returned to pitching. Average DASH score was 1.36, whereas the average Sport-Specific DASH score was 1.7. Gains were observed in both elbow flexion (125.45° to 141.36°) and extension (20.45° to 4.55°).

One wound infection occurred but did not impact return-to-play and was resolved with debridement and antibiotics. No complications or donor-site morbidity related to graft harvest were found.

Future research should focus on “long-term outcomes in terms of prevention of degenerative changes and their long-term activities and potentially technical advances to preserve the lateral collateral ligament,” study author and presenter, Matthew Lawrence Lyons, MD, concluded. — by Christian Ingram

Reference:

Lyons ML. Paper #14. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 10-13, 2014; Seattle.