Arthroscopic treatment of osteochondritis dissecans of the elbow in adolescents
Young-Lae Moon, Dong-Hui Kim, Sang-Ho Ha
Department of Orthopedics Surgery, Chosun University, Gwangju, Korea
Keywords: Athletic injuries/surgery; elbow joint/injuries/surgery; joint loose bodies/surgery; osteochondritis dissecans/surgery; treatment outcome.
Objectives: We evaluated the results of arthroscopic management of osteochondritis dissecans (OD) of the elbow in adolescents.
Patients and methods: Seven patients with OD (age range 13 to 20 years) underwent arthroscopic surgery involving removal of the loose bodies followed by multiple drilling with a K-wire. Four patients were professional athletes and three patients enjoyed playing softball. There was pain on exertion in all the patients, accompanied by locking in five patients, joint effusion in two patients, and snap in one patient. The mean articular range of motion was 121° (range 105° to 145°), and the mean flexion contracture was 8°. Radiographic studies showed changes in the capitellum of the humerus and loose bodies within the joint. The results were evaluated using the Broberg and Morrey's scoring system. Medial instability of the elbow was compared with the normal side using the method of Conway et al. The mean follow-up period was 19.7 months (range 16 to 28 months).
Results: According to the Broberg and Morrey's evaluation system, the results were excellent in two patients (28.6%), and good in five patients (71.4%). Normal range of motion was achieved in all the patients and all returned to a normal living within an average of 7.3 days (range 5 to 11 days). The results of treatment were good in four professional athletes, but none could return to their professions. Compared to the healthy side, valgus instability test showed 3 mm difference in two patients and 1 mm difference in one patient, but this did not affect their living.
Conclusion: Arthroscopic surgery of the elbow has proven to be safe and effective in the treatment of loose bodies of the elbow and other associated pathologies.