The Arthroscopic Classification and Treatment of Osteochondritis Dissecans of the Capitellum

Abstract

This study was done to determine the results of the arthroscopic treatment of osteochondritis dissecans of the capitellum in a young population. A retrospective review of 16 patients (17 elbows) was performed by follow-up examination and radiographs. The average follow-up was 48 months, with a minimum of 24 months. All patients underwent abrasion chondroplasty of the lesion and removal of any loose bodies and osteophytes when present. Postoperatively, the average flexion contracture decreased by 14°, and the average extension contracture decreased by 6°. Two of nine patients gave up participation in throwing sports, and one of five gave up gymnastics. All others returned to their preoperative levels of activity. Radiographs showed some slight residual flattening of the capitellum in eight patients. Two patients required re-operation: one for arthrofibrosis and one for a suspected loose body. The results of this study suggest that arthroscopic abrasion chondroplasty and treatment of any accompanying pathologic lesions in the affected elbow gave good results in most patients. This is a short-term study in a young population. Further follow-up will be needed to determine any long-term problems with this type of treatment. An arthroscopic classification system has also been proposed.