Sequential alterations in magnetic resonance imaging findings after autologous osteochondral mosaicplasty for young athletes with osteochondritis dissecans of the humeral capitellum.
BACKGROUND
The goal of osteochondral mosaicplasty (mosaicplasty) against osteochondritis dissecans of the humeral capitellum (capitellar OCD) is to allow patients to return to their sports activities without functional disturbance of the affected elbow. Consequently, the rehabilitation protocol and the interval before returning to sports activities must be established. Although surgeons need this type of data for establishing sequential alterations of grafts in the elbow, no such data have been published.


OBJECTIVE
The findings of magnetic resonance imaging (MRI) improve with increasing time after mosaicplasty for capitellar OCD.


METHODS
Case series; Level of evidence, 4.


METHODS
Ten young male athletes with advanced lesions of capitellar OCD, treated with mosaicplasties, underwent MRI scans at 3, 6, and 12 months, postoperatively. The surgical technique involved obtaining small-sized cylindrical osteochondral grafts from the lateral periphery of the femoral condyle at the level of the patellofemoral joint and transplanting them to the capitellar lesion. The MRI findings were semiquantitatively assessed according to the scoring system of Henderson et al (4, normal; 16, no repair).


RESULTS
At 12 months, all patients returned to their competitive level of sports without any disturbances of the operated elbow. Fluid surrounding the graft was found in all patients at 3 months and 4 patients at 6 months. The grafts were all well seated within the recipient sites, with no MRI evidence of graft loosening at 12 months. The overall MRI scores significantly improved from 3 to 12 months.


CONCLUSIONS
The MRI findings indicate that the graft incorporation to the surrounding tissues occurs around or after 6 months, postoperatively. This finding suggests that rehabilitation precautions be taken for up to 6 months after mosaicplasty for young athletes with capitellar OCD.
Iwasaki
Norimasa
N
Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Kita 15, Nishi 7, Sapporo 060-8638, Japan. niwasaki@med.hokudai.ac.jp
Kato
Hiroyuki
H
Kamishima
Tamotsu
T
Minami
Akio
A
D000293:Adolescent; D001265:Athletic Injuries / Q000601:surgery; D002358:Cartilage, Articular / Q000601:surgery*; D002648:Child; D004551:Elbow Joint / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D019637:Orthopedic Procedures; D010008:Osteochondritis Dissecans / Q000503:physiopathology / Q000601:surgery*; D013514:Surgical Procedures, Operative / Q000592:standards; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D000092464:Elbow Injuries