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First published on March 27, 2006, doi:10.1177/0363546506286343
This version was published on August 1, 2006
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The American Journal of Sports Medicine 34:1233-1239 (2006)
© 2006 American Orthopaedic Society for Sports Medicine

Autologous Osteochondral Mosaicplasty for Capitellar Osteochondritis Dissecans in Teenaged Patients

Norimasa Iwasaki, MD, PhD*,{dagger}, Hiroyuki Kato, MD, PhD{ddagger}, Jyunichi Ishikawa, MD, PhD{dagger}, Satoru Saitoh, MD{ddagger} and Akio Minami, MD, PhD{dagger}

From the {dagger} Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Sapporo, Japan, and the {ddagger} Department of Orthopaedic Surgery, Shinsyu University School of Medicine, Matsumoto, Japan

* Address correspondence to Norimasa Iwasaki, MD, PhD, Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Kita 15, Nishi 7, Sapporo 060-8638, Japan (e-mail: niwasaki{at}med.hokudai.ac.jp).

Background: Autologous osteochondral mosaicplasty is a new technique to provide hyaline repair for articular defects. Although recent studies have reported the successful treatment of articular defects in the knee and ankle joints with this surgical procedure, little attention has been given to the surgical efficacy of mosaicplasty in the treatment of osteochondritis dissecans of the humeral capitellum.

Purpose: To clarify the clinical outcomes of mosaicplasty for teenaged patients with advanced lesions of capitellar osteochondritis dissecans.

Study Design: Case series; Level of evidence, 4.

Methods: Eight teenaged patients with advanced lesions of capitellar osteochondritis dissecans underwent mosaicplasties. All patients were baseball players who were affected on the right side, which was also their throwing side. The surgical technique involves obtaining small-sized cylindrical osteochondral grafts from the lateral periphery of the femoral condyles and transplanting them to prepared osteochondral defects. At a mean follow-up of 24 months, all patients were evaluated clinically and radiographically.

Results: Seven of the 8 patients were free from elbow pain, and the remaining patient had mild pain occasionally. The mean clinical score described by Timmerman and Andrews (a maximum of 200 points) significantly improved from 140 points to 183 points postoperatively. All patients except one had excellent or good clinical results. Radiographically, the graft incorporation and a normal contour of the subchondral cortex were found in all patients. Magnetic resonance imaging showed that the preoperative heterogeneity of the lesion had disappeared and the signal intensity returned to normal. Six of the 8 patients, including all 3 pitchers, returned to competitive-level baseball.

Conclusion: Mosaicplasty for advanced lesions of capitellar osteochondritis dissecans in teenaged baseball players can provide satisfactory clinical and radiographic results.

Key Words: osteochondritis dissecans • elbow joint • mosaicplasty • teenager




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