Abstract
Autologous osteochondral transplantation is an established surgical procedure for osteochondritis dissecans (OCD) of the knee, and has recently been applied in cases of advanced-staged OCD of the elbow. The elbow procedure; however, is more technically demanding than for the knee. One reason is the difficulties of perpendicular insertion of large-diameter osteochondral plugs to the humeral capitellum with a small, narrow operative field in the humeroradial joint. Furthermore, if the OCD lesion is located on the lateral site of the capitellum, the creation of recipient holes perpendicular to the joint surface is difficult due to the risk of damaging the lateral wall of the capitellum. To avoid such difficulties, we developed a new technique by which 6.5 and/or 8.5 mm diameter plugs are harvested from the ipsilateral knee, having an oblique cartilage surface relative to the long axis of the plugs. These are then inserted into the recipient holes which are created obliquely from the lateral and distal to medial and proximal directions in the capitellum at an angle complimentary to the harvested plugs. This technique allows easy insertion of large-diameter plugs into recipient holes in a restricted operative field, even if the OCD lesion is located in the lateral site.
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References
Bauer M, Jonsson K, Josefson PO, Linden B (1992) Osteochondritis dissecans of the elbow: a long-term follow-up study. Clin Orthop Relat Res 284:156–160
Carter DR, Beaupré GS, Wong M, Smith RL, Andriacchi TP, Schurman DJ (2004) The mechanobiology of articular cartilage development and degeneration. Clin Orthop Relat Res 427(suppl):S69–S77
Feczkó P, Hangody L, Varga J, Bartha L, Diószegi Z, Bodó G, Kendik Z, Módis L (2003) Experimental results of donor site filling for autologous osteochondral mosaicplasty. Arthroscopy 19:755–761
Hangody L, Feczkó P, Bartha L, Bodo G, Kish G (2001) Mosaicplasty for the treatment of articular defects of the knee and ankle. Clin Orthop Relat Res 391:328–336
Hangody L, Füles P (2003) Autologous osteochondral mosaicplasty for the treatment of full-thickness defects of weight-bearing joints: ten years of experiment and clinical experience. J Bone Joint Surg Am 85:25–32
Iwasaki N, Kato H, Ishikawa J, Saitoh S, Minami A (2006) Autologous osteochondral mosaicplasty for capitellar osteochondritis dissecans in teenaged patients. Am J Sports Med 34:1233–1239
Iwasaki N, Kato H, Kamishima T, Suenaga N, Minami A (2007) Donor site evaluation after autologous osteochondral mosaicplasty for cartilaginous lesions of the elbow joint. Am J Sports Med 35:2096–2100
Menche DS, Vangsness CT Jr, Pitman M, Gross AE, Peterson L (1998) The treatment of isolated articular cartilage lesion in young individual. Instr Course Lect 47:505–515
Nakagawa Y, Matsusue Y, Ikeda N, Asada Y, Nakamura T (2001) Osteochondral grafting and arthroplasty for end-stage osteochondritis dissecans of the capitellum. Am J Sports Med 29:650–655
Peterson RK, Savoie FH, Field LD (1999) Osteochondritis dissecans of the elbow. Instr Course Lect 48:393–398
Singer KM, Roy SP (1984) Osteochondritis of the humeral capitellum. Am J Sports Med 12:351–360
Yamamoto Y, Ishibashi Y, Tsuda E, Sato H, Toh S (2006) Osteochondral autograft transplantation for osteochondritis dissecans of the elbow in juvenile baseball players: minimum 2-year follow-up. Am J Sports Med 34:714–720
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Miyamoto, W., Yamamoto, S., Kii, R. et al. Oblique osteochondral plugs transplantation technique for osteochondritis dissecans of the elbow joint. Knee Surg Sports Traumatol Arthrosc 17, 204–208 (2009). https://doi.org/10.1007/s00167-008-0636-5
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DOI: https://doi.org/10.1007/s00167-008-0636-5