Osteochondral autologous transplantation may be effective for osteochondritis dissecans
Key takeaways:
- Results showed athletes who received osteochondral autologous transplantation successfully returned to sport.
- All patients also experienced pain relief.
SAN DIEGO — Osteochondral autologous transplantation may be an effective treatment option for adolescent athletes with capitellar osteochondritis dissecans, according to results presented here.
“This study has identified synovial inflammation as a significant component of the disease process,” Jose M. Gutierrez-Naranjo, MD, research fellow at Hospital for Special Surgery, said in his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting. “We found [osteochondral autologous transplantation surgery (OATS)] to effectively restore the osteochondral architecture, leading to long-term pain relief and preserved function in adolescent athletes.”
Gutierrez-Naranjo, Robert N. Hotchkiss, MD, and colleagues retrospectively reviewed data from 17 adolescent athletes (mean age, 14 years; 15 men, two women) with capitellar osteochondritis dissecans who underwent osteochondral autologous transplantation surgery between 2009 and 2023.
According to Hotchkiss, hand and upper extremity surgeon at Hospital for Special Surgery, all of the athletes involved in the study successfully returned to their sport of choice, except for one patient who chose not to return for personal reasons.
In his presentation, Gutierrez-Naranjo said 53% of patients experienced papillary hypertrophy and 59% experienced mucoid/myxomatous degeneration intraoperatively. In addition, every patient experienced pain relief and mean extension-flexion range of motion improved from 127° to 137°.
He added that every graft was incorporated successfully, according to postoperative MRIs.
“If the elbow has lost mobility and the joint has an effusion and is inflamed, then generally that means part of the cartilage is starting to break off, and the inflammation is a reaction to your own joint falling apart,” Hotchkiss told Healio. “I do not see a reason for waiting. It is one of the few things where I think being a bit more proactive, especially if you have MRI evidence of delamination of the cartilage — just do it.”
He added, “If you line it up right and put in the right amount, they will come back [to sport]. Seldom do you operate on something and it is gone, it never comes back, it does not wear out and you are finished. We do not get that opportunity a lot of times.”
For more information:
Robert N. Hotchkiss, MD, can be reached at rennichr@hss.edu.
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Tadley M, et al. Paper 398. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 10-14, 2025; San Diego.