title: State of the art: Elbow arthroscopy: review of the literature and application for osteochondritis dissecans of the capitellum.
abstract: Elbow arthroscopy has become a safe and effective treatment option for a number of elbow disorders. The most rewarding and successful indication is the removal of loose bodies. Loose bodies are often a result of osteochondritis dissecans (OCD) of the capitellum, and arthroscopy in this case is useful for performing debridement, thereby eliminating the need for a more extensive open procedure associated with complications. In this review, we describe our arthroscopic technique for OCD of the capitellum. We usually conduct arthroscopy in the supine position, and use 2.9-mm arthroscopes of 30° and 70°. The 70° arthroscope provides a greater operative field than the 30° arthroscope. Arthroscopic treatment for OCD may require 2 anterior and 2 posterior portals. Loose bodies are commonly found in the radial fossa, coronoid fossa, and in the olecranon fossa. Once the loose bodies are removed, all unstable cartilage of the capitellum lesion is removed to create a stable bed. If any sclerotic changes to the lesion bed are observed, we create microfractures in the lesion bed. The most significant complication in arthroplasty is neurovascular injury. However, we have never experienced this devastating complication, which can be avoided by paying careful attention to detail.
authors.affiliation: Department of Orthopedics, the University of Tokushima.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Matsuura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Egawa
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Takahashi
authors.forename: Kosaku
authors.initials: K
authors.lastname: Higashino
authors.forename: Toshinori
authors.initials: T
authors.lastname: Sakai
authors.forename: Naoto
authors.initials: N
authors.lastname: Suzue
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hamada
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Goto
authors.forename: Yoichiro
authors.initials: Y
authors.lastname: Takata
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Nishisho
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Goda
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Sato
authors.forename: Ichiro
authors.initials: I
authors.lastname: Tonogai
authors.forename: Kenji
authors.initials: K
authors.lastname: Kondo
authors.forename: Fumitake
authors.initials: F
authors.lastname: Tezuka
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Mineta
authors.forename: Kosuke
authors.initials: K
authors.lastname: Sugiura
authors.forename: Makoto
authors.initials: M
authors.lastname: Takeuchi
authors.forename: Koichi
authors.initials: K
authors.lastname: Sairyo
mesh_terms: D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods*; D004551:Elbow Joint / Q000601:surgery*; D006801:Humans; D010008:Osteochondritis Dissecans / Q000601:surgery*; D011182:Postoperative Care