title: Donor-site morbidity after osteochondral autologous transplantation for osteochondritis dissecans of the capitellum: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To determine the rate of donor-site morbidity after osteochondral autologous transplantation (OATS) for capitellar osteochondritis dissecans.
  
  
  METHODS
  A literature search was performed in PubMed/MEDLINE, Embase, and Cochrane Library to identify studies up to November 6, 2016. Criteria for inclusion were OATS for capitellar osteochondritis dissecans, reported outcomes related to donor sites, ≥10 patients, ≥1 year follow-up, and written in English. Donor-site morbidity was defined as persistent symptoms (≥1 year) or cases that required subsequent intervention. Patient and harvest characteristics were described, as well as the rate of donor-site morbidity. A random effects model was used to calculate and compare weighted group proportions.
  
  
  RESULTS
  Eleven studies including 190 patients were included. In eight studies, grafts were harvested from the femoral condyle, in three studies, from either the 5th or 6th costal-osteochondral junction. The average number of grafts was 2 (1-5); graft diameter ranged from 2.6 to 11 mm. In the knee-to-elbow group, donor-site morbidity was reported in 10 of 128 patients (7.8%), knee pain during activity (7.0%) and locking sensations (0.8%). In the rib-to-elbow group, one of 62 cases (1.6%) was complicated, a pneumothorax. The proportion in the knee-to-elbow group was 0.04 (95% CI 0.0-0.15), and the proportion in the rib-to-elbow group was 0.01 (95% CI 0.00-0.06). There were no significant differences between both harvest techniques (n.s.).
  
  
  CONCLUSIONS
  Donor-site morbidity after OATS for capitellar osteochondritis dissecans was reported in a considerable group of patients.
  
  
  METHODS
  Level IV, systematic review of level IV studies.
authors.affiliation: Department of Orthopaedic Surgery, Sports Medicine Service, Massachusetts General Hospital, Harvard Medical School, 175 Cambridge Street, Boston, MA, 02114, USA. rensbexkens@gmail.com.|Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. rensbexkens@gmail.com.
authors.forename: Rens
authors.identifier: http://orcid.org/0000-0001-6993-0941
authors.initials: R
authors.lastname: Bexkens
authors.affiliation: Department of Orthopaedic Surgery, Sports Medicine Service, Massachusetts General Hospital, Harvard Medical School, 175 Cambridge Street, Boston, MA, 02114, USA.
authors.forename: Paul T
authors.initials: PT
authors.lastname: Ogink
authors.affiliation: Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Job N
authors.initials: JN
authors.lastname: Doornberg
authors.affiliation: Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.|Academic Center for Evidence based Sports medicine (ACES), Amsterdam, The Netherlands.|Amsterdam Collaboration for Health and Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands.
authors.forename: Gino M M J
authors.initials: GMMJ
authors.lastname: Kerkhoffs
authors.affiliation: Department of Orthopaedic Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.|Department of Orthopaedic Surgery, Amphia Hospital, Molengracht 21, 4818 CK, Breda, The Netherlands.
authors.forename: Denise
authors.initials: D
authors.lastname: Eygendaal
authors.affiliation: Department of Orthopaedic Surgery, Sports Medicine Service, Massachusetts General Hospital, Harvard Medical School, 175 Cambridge Street, Boston, MA, 02114, USA.
authors.forename: Luke S
authors.initials: LS
authors.lastname: Oh
authors.affiliation: Department of Orthopaedic Surgery, Shoulder and Elbow Unit, Onze Lieve Vrouwe Gasthuis, Oosterpark 9, 1091 AC,, Amsterdam, The Netherlands.
authors.forename: Michel P J
authors.initials: MPJ
authors.lastname: van den Bekerom
mesh_terms: D018771:Arthralgia / Q000209:etiology; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods*; D004551:Elbow Joint / Q000601:surgery*; D005269:Femur / Q000637:transplantation; D006801:Humans; D007719:Knee Joint / Q000473:pathology; D010008:Osteochondritis Dissecans / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications / Q000473:pathology*; D012272:Ribs / Q000637:transplantation; D060053:Transplant Donor Site / Q000473:pathology*; D014182:Transplantation, Autologous
keywords: Capitellum; Donor-site morbidity.; Graft harvesting; Knee; Osteochondral autologous transplantation; Osteochondritis dissecans