Osteochondritis dissecans of the elbow: excellent results in teenage athletes treated by arthroscopic debridement and microfracture

Bojanić, Ivan and Smoljanović, Tomislav and Dokuzović, Stjepan (2012) Osteochondritis dissecans of the elbow: excellent results in teenage athletes treated by arthroscopic debridement and microfracture. Croatian Medical Journal, 53 (1). pp. 40-47. ISSN 0353-9504

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Abstract

AIM: To evaluate the outcome of patients who underwent microfracture procedure on osteochondritis dissecans (OCD) lesions in the elbow, which had already been proven successful on OCD lesions in the knee and ankle. ----- METHODS: Nine young patients who were previously treated by arthroscopic debridement and microfracture by a single surgeon were included in the study. The median age at operation was 15 years (range 12-19). The median time between the procedure and evaluation was 5 years (range 2-9). The evaluation included physical examination and patient interview with elbow function scoring. Success of treatment was determined according evaluation Mayo Elbow Performance Index scores and the patients' return to sports. ----- RESULTS: Eight patients scored excellent results and 1 scored a good result. Four out of 9 patients were able to increase their training intensity, 2 returned to the same level of activity, 2 changed sports (due to reasons unrelated to the health of their elbow), and 1 left professional sports and started training only recreationally. No patients stopped participating in sports altogether. ----- CONCLUSIONS: We advocate arthroscopic microfracturing, followed by a strict rehabilitation regime, as a highly effective treatment for OCD of the humeral capitellum.

Abstract in Croatian

Osteohondritis disekans lakta: odlični rezultati kod sportaša tinejdžerske dobi koji su liječeni artroskopskim debridementom i mikrofrakturom ----- Cilj Utvrditi ishod kod pacijenata s osteohondritis disekansom lakta koji su liječeni postupkom mikrofrakture, koji se već prije pokazao uspješnim kod osteohondritis disekansa koljena i gležnja. ----- Postupci Istraživanje je uključilo 9 mladih pacijenata koji su ranije liječeni postupkom artroskopskog debridementa i mikrofrakture kod istog kirurga. Medijan dobi za vrijeme zahvata bio je 15godina (raspon 12-19). Medijan vremena između zahvata i procjene bio je 5 godina (raspon 2-9). Procjena je uključila liječnički pregled i razgovor s pacijentom uključujući određivanje funkcije lakta. Uspjeh liječenja određen je Mayo indeksom za procjenu funkcije lakta i povratkom pacijenata bavljenju sportom. ----- Rezultati Osam pacijenata pokazalo je odlične rezultate a jedan je pokazao dobar rezultat. Četiri pacijenta povisila su intenzitet treniranja, 2 su ostala na istoj razini aktivnosti, 2 su promijenila sport (zbog razloga nevezanih za stanje njihovog lakta), a 1 je napustio profesionalno bavljenje sportom i počeo trenirati samo rekreativno. Nitko od pacijenata nije se u potpunosti prestao baviti sportom. ----- Zaključak Zagovaramo uporabu artroskopskog liječenja mikrofrakturom, nakon kojeg slijedi strogi rehabilitacijski režim, za učinkovito liječenje osteohondritis disekansa lakta.

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