title: Osteochondral autograft plug transfer for treatment of osteochondritis dissecans of the capitellum in adolescent athletes.
abstract: BACKGROUND
  Osteochondritis dissecans (OCD) of the capitellum is a condition most commonly seen in adolescents involved in repetitive overhead sports and can profoundly affect ability to return to play and long-term elbow function. Treatment of large, unstable defects in the elbow with osteochondral autograft plug transfer has not been adequately studied.
  
  
  METHODS
  We retrospectively identified 11 teenaged patients with large (>1 cm(2)) capitellar OCD treated with osteochondral autograft plug transfer. Average age at the time of surgery was 14.5 years (range, 13-17 years). Outcome measures obtained included return to play, preoperative and postoperative elbow range of motion, Disabilities of Arm, Shoulder and Hand (DASH; Institute for Work and Health, Toronto, ON, Canada) by telephone interview, and osseous integration on radiographs. All 11 patients were available for evaluation at an average of 22.7 months (range, 6-49 months) postoperatively.
  
  
  RESULTS
  All patients were involved in competitive high school athletics and returned to at least their preinjury level of play. Average return to play was 4.4 months (range 3-7 months). The average final DASH was 1.4 (95% confidence interval, 0.6-2.1), and the average final sport-specific DASH was 1.7 (95% confidence interval -1.8 to 5.2). Elbow range of motion significantly improved, including improvement in flexion from a preoperative average of 126° to a postoperative average of 141° (P = .009) and improvement in extension from a preoperative average of 21° to a postoperative average of 5° (P = .006).
  
  
  CONCLUSIONS
  Treatment of large, unstable OCD lesions of the capitellum in adolescent athletes allows reliable return to play, is safe, and has good clinical outcomes at short-term follow-up.
authors.affiliation: Group Health Bellevue Medical Center, Bellevue, WA, USA.
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Lyons
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA, USA.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Werner
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA, USA.
authors.forename: Joshua S
authors.initials: JS
authors.lastname: Gluck
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA, USA.
authors.forename: Aaron M
authors.initials: AM
authors.lastname: Freilich
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA, USA.
authors.forename: A Rashard
authors.initials: AR
authors.lastname: Dacus
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Diduch
authors.affiliation: Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, VA, USA. Electronic address: ac2h@virginia.edu.
authors.forename: A Bobby
authors.initials: AB
authors.lastname: Chhabra
mesh_terms: D000293:Adolescent; D001182:Arthroscopy; D001265:Athletic Injuries / Q000601:surgery*; D016025:Bone Transplantation; D002356:Cartilage / Q000637:transplantation; D012090:Cumulative Trauma Disorders / Q000601:surgery; D004551:Elbow Joint / Q000601:surgery*; D005260:Female; D006801:Humans; D006811:Humerus / Q000601:surgery*; D008297:Male; D010008:Osteochondritis Dissecans / Q000601:surgery*; D012189:Retrospective Studies; D000068958:Return to Sport; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D000092464:Elbow Injuries
keywords: Elbow; adolescent athlete; capitellar osteochondritis dissecans; osteochondral autograft plug transfer; return to play