Short-term results of arthroscopic micro-fracture and autologous osteochondralplasty for osteochondritis dissecans of elbow

Abstract

Objective To evaluate the short-term results of arthroscopic treatment including micro-fractures and autologous osteochondralplasty for osteochondritis dissecans (OCD) of elbow. Methods Data of 30 OCD patients who were treated by arthroscopic micro-fracture or autologous osteochondralplasty from January 2012 to December 2014 were retrospectively analyzed. 22 of them were followed-up for more than one year. Among them, there were 20 males and 2 females. All had OCD lesion on dominated side. The average age was 15 years old (range, 12-19 years old). All patients suffered from pain and limitation on the range of motion at different level. Arthroscopic micro-fracture was performed if the diameter of the lesion was less than 1 cm, otherwise, autologous osteochondralplasty was performed. 16 cases received arthroscopic micro-fracture and 6 cased received autologous osteochondralplasty. 6 patients were athletes who received micro-fracture. 16 patients were non-athletes and 10 of them received micro-fractures. The flexion-extension range of motion(ROM), Mayo elbow performance score (MEPS), visual analog scale for pain (VAS) were recorded preoperatively and at the final follow-up for comparison. Results Patients were followed up for 13 month on average (range, 12-18 months) without any complications. All patients got improvement significantly with 100% good or excellent rate. For patients receiving arthroscopic micro-fracture, the preoperative ROM, MEPS and VAS was 101.88°±14.82°, 64.38±4.79 and 5.13±1.09, which was improved to 114.38°±11.53°, 88.75±8.06 and 0.88±1.02 respectively. There were significant differences between preoperative and postoperative ROM, MEPS and VAS. Among these 16 patients, 13 were excellent and 3 were good. For 6 patients who received arthroscopic autologous osteochondralplasty, the preoperative ROM, MEPS and VAS was 105.00°±11.83°, 60.83±6.11 and 5.67±1.37, which was improved to 120.83°±6.11°, 87.50±5.24 and 1.17±0.56 at the final follow up respectively. There were significant differences between preoperative and postoperative ROM, MEPS and VAS. Among these 6 patients, 4 were excellent and 2 were good. Conclusion For elbow OCD, satisfied result can be expected by arthroscopic micro-fracture and autologous osteochondralplasty because both are effective procedures to improve the elbow function. Key words: Arthroscopy; Elbow joint; Transplantation, autologous