title: Outcomes of arthroscopic treatment of osteochondritis dissecans of the capitellum and description of the technique.
abstract: OBJECTIVE
  We hypothesize that a technique for all-arthroscopic fixation of capitellum osteochondritis dissecans (OCD) lesions using suture fixation and autogenous iliac crest bone grafting offers a successful alternative to open internal fixation techniques as shown by 2-year validated patient-reported outcomes.
  
  
  METHODS
  Our technique uses arthroscopic all-inside suture fixation with iliac crest autogenous bone grafting. The procedure was performed on 4 elite-level, adolescent athletes presenting with 5 unstable capitellum OCD lesions resulting in elbow pain, limited range of motion, and decreased ability to play. Magnetic resonance imaging showed an unstable OCD lesion, which was correlated with arthroscopy. Postoperatively, patients were evaluated by the short version of the Disabilities of the Arm, Shoulder and Hand questionnaire; Oxford Elbow and Mayo Elbow scores; visual analog scale; postoperative range of motion; and return to play.
  
  
  RESULTS
  Three female patients and one male patient aged 13 to 15 years underwent the procedure. The mean final follow-up period was 2.8 years. Union was achieved in all patients, as seen on magnetic resonance imaging at a mean of 3 months. At follow-up, the mean loss of extension was 2°. Mean flexion was 153°. There was no loss of supination or pronation. The mean score on the short version of the Disabilities of the Arm, Shoulder and Hand questionnaire was 11. The mean Mayo Elbow score was 88. The mean Oxford Elbow score was 42. The mean visual analog scale score was 2. The mean time to return to play was 4 months. All patients continued to compete at an elite level. There were no infections or cases of fixation failure, and no patients required conversion to open surgery or needed revision surgery.
  
  
  CONCLUSIONS
  Arthroscopic all-inside fixation of unstable OCD lesions is a successful technique, facilitating athletes to return to an elite level of play.
authors.affiliation: Department of Orthopaedic Surgery, Mount Sinai Hospital, Mount Sinai Health System, New York, NY, USA.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Koehler
authors.affiliation: Department of Orthopaedic Surgery, Mount Sinai Hospital, Mount Sinai Health System, New York, NY, USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Walsh
authors.affiliation: Department of Orthopaedic Surgery, Mount Sinai Hospital, Mount Sinai Health System, New York, NY, USA.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Lovy
authors.affiliation: Department of Orthopaedic Surgery, Mount Sinai Hospital, Mount Sinai Health System, New York, NY, USA.
authors.forename: Jason S
authors.initials: JS
authors.lastname: Pruzansky
authors.affiliation: Department of Orthopaedic Surgery, Mount Sinai Hospital, Mount Sinai Health System, New York, NY, USA.
authors.forename: Dave R
authors.initials: DR
authors.lastname: Shukla
authors.affiliation: Department of Orthopaedic Surgery, Mount Sinai Hospital, Mount Sinai Health System, New York, NY, USA. Electronic address: michael.hausman@mountsinai.org.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Hausman
mesh_terms: D000293:Adolescent; D018771:Arthralgia / Q000209:etiology; D001182:Arthroscopy / Q000379:methods*; D016025:Bone Transplantation; D004551:Elbow Joint / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010008:Osteochondritis Dissecans / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D011403:Pronation; D016059:Range of Motion, Articular; D000068958:Return to Sport; D013484:Supination; D011795:Surveys and Questionnaires; D013536:Suture Techniques; D016896:Treatment Outcome
keywords: Arthroscopy; all inside; elbow; osteochondritis dissecans