Cylindrical Costal Osteochondral Autograft for Reconstruction of Large Defects of the Capitellum Due to Osteochondritis Dissecans: Surgical Technique.

Abstract

We describe our technique of cylindrical costal osteochondral autograft for elbows with advanced osteochondritis dissecans. Mark the ipsilateral (fifth or sixth) rib. Debride necrotic fibrous tissue completely. Elevate the graft carefully from the periosteum and perichondrium to avoid damage to the pleura. Shape the harvested osteochondral junction like a cone about 18 mm in height, including a 5-mm-high cartilage cap. After packing the grafts, shape and contour the cartilage surface to fit the radial head using a scalpel. Most patients are able to perform normal daily activities in a few days or a week, but they are not allowed to play sports for three months. Between 2006 and 2010, we performed this operation in forty-three patients with severe osteochondritis dissecans of the humeral capitellum, and twenty-six cases were followed for more than twenty-four months12. IndicationsContraindicationsPitfalls & Challenges.