title: Return to Sport After Operative Management of Osteochondritis Dissecans of the Capitellum: A Systematic Review and Meta-analysis.
abstract: BACKGROUND
  Capitellar osteochondritis dissecans (OCD) is commonly managed surgically in symptomatic adolesent throwers and gymnasts. Little is known about the impact that surgical technique has on return to sport.
  
  
  OBJECTIVE
  To evaluate the clinical outcomes and return-to-sport rates after operative management of OCD lesions in adolescent athletes.
  
  
  METHODS
  Systematic review; Level of evidence, 4.
  
  
  METHODS
  The PubMed, CINAHL, EMBASE, SPORTDiscus (EBSCO), and Cochrane Central Register of Controlled Trials databases were queried for studies evaluating outcomes and return to sport after surgical management of OCD of the capitellum. Two independent reviewers conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies reporting patient outcomes with return-to-sport data and minimum 6-month follow-up were included in the review.
  
  
  RESULTS
  After review, 24 studies reporting outcomes in 492 patients (mean age ± SD, 14.3 ± 0.9 years) were analyzed. The overall return-to-sport rate was 86% at a mean 5.6 months. Return to the highest preoperative level of sport was most common after osteochondral autograft procedures (94%) compared with debridement and marrow stimulation procedures (71%) or OCD fixation surgery (64%). Elbow range of motion improved by 15.9° after surgery. The Timmerman-Andrews subjective and objective scores significantly improved after surgery. Complications were low (<5%), with 2 cases of donor site morbidity after osteoarticular autograft transfer (OAT) autograft harvest. The most common indications for reoperation were repeat debridement/loose body removal.
  
  
  CONCLUSIONS
  A high rate of return to sport was observed after operative management of capitellar OCD. Patients were more likely to return to their highest level of preoperative sport after OAT autograft compared with debridement or fixation. Significant improvements in elbow range of motion and patient outcomes are seen with low complication rates after OCD surgery.
authors.affiliation: Department of Orthopedics and Rehabilitation and UI Sports Medicine, University of Iowa, Iowa City, Iowa, USA.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Westermann
authors.affiliation: Department of Orthopedics and Rehabilitation and UI Sports Medicine, University of Iowa, Iowa City, Iowa, USA.
authors.forename: Kyle J
authors.initials: KJ
authors.lastname: Hancock
authors.affiliation: Department of Orthopedics and Rehabilitation and UI Sports Medicine, University of Iowa, Iowa City, Iowa, USA.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Buckwalter
authors.affiliation: Department of Orthopedics and Rehabilitation and UI Sports Medicine, University of Iowa, Iowa City, Iowa, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Kopp
authors.affiliation: Department of Orthopedics and Rehabilitation and UI Sports Medicine, University of Iowa, Iowa City, Iowa, USA.
authors.forename: Natalie
authors.initials: N
authors.lastname: Glass
authors.affiliation: Department of Orthopedics and Rehabilitation and UI Sports Medicine, University of Iowa, Iowa City, Iowa, USA.
authors.forename: Brian R
authors.initials: BR
authors.lastname: Wolf
keywords: OATs; elbow; gymnast; osteochondritis dissecans; return to sport; thrower