Arthroscopic debridement of osteochondritis dissecans may yield satisfactory outcomes
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TAMPA, Fla. — Most adolescent patients with an osteochondritis dissecans lesion of the capitellum experienced satisfactory long-term functional and pain outcomes with arthroscopic debridement, according to results presented here.
Daniel C. Austin, MD, MS, of Dartmouth-Hitchcock Medical Center, and colleagues identified 53 patients 18 years of age and younger who underwent arthroscopic debridement for osteochondritis dissecans of the capitellum between 1999 and 2015 and had at least a 5-year follow-up.
“We worked to get in touch with them to see how they were doing through any means possible,” Austin told Healio about the study, which was carried out at the Mayo Clinic. “We used email, phone [and] virtual video visits, and we also used clinical visits when they were available.”
Austin noted clinical outcome scores included the VAS pain scale, the summary outcome determination score and QuickDASH scores. He added they also collected range of motion when possible.
“The summary outcome determination, the SOD score, suggested that 96% of patients were better than before surgery, 83% were almost normal and only 4% were worse than before,” Austin said in his presentation at the American Shoulder and Elbow Surgeons Annual Meeting.
Patients had an average QuickDASH score of 4, with a range from 0 to 52, according to Austin. Of the 80% of patients who were able to return to sport, Austin noted 56% were able to return to sport at the same level before injury.
“Although patients did improve their range of motion after surgery, from 115° to 130° on average, 130° is still not normal,” Austin told Healio. “It’s lacking 10° for the normal person. So, even though the patients were doing well overall, there was evidence that a lot of them still had a flexion contracture.”
He added 9% of elbows required revision surgery, leading to a survival free of revision of 90% at 5 years.
“I think [these results] solidify arthroscopic debridement as first-line treatment for well-contained osteochondritis dissecans of the capitellum,” Austin told Healio.
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Austin DC, et al. Paper 35. Presented at: American Shoulder and Elbow Surgeons Annual Meeting; Dec. 15-17, 2021; Tampa, Fla.
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