Advertisement

Osteochondritis Dissecans of the Elbow: Classification and Treatment Rationale

  • Rens Bexkens
  • Nick F. J. Hilgersom
  • Denise Eygendaal
Chapter

Abstract

Magnetic resonance imaging and computed tomography are indicated to assess osteochondritis dissecans for lesion stability and associated loose bodies, respectively. In general, osteochondritis dissecans can be distinguished into a stable or unstable lesion. For stable lesions in an immature patient, nonoperative treatment is advocated and consists of immediate cessation of sporting activities, analgesics, and strengthening exercises. For unstable lesions or stable lesions that do not respond to appropriate nonoperative treatment, a surgical approach is recommended. Many different techniques have been described over the past two decades. In this chapter we provide an overview of the existing classification systems, as well as a treatment rationale including the most commonly performed surgical techniques for capitellar osteochondritis dissecans.

Notes

Acknowledgment

None.

Conflict of Interest: R. Bexkens R and N.F.J. Hilgersom have no conflicts of interest or financial ties to disclose. D. Eygendaal is a consultant for Lima Elbow System and a speaker for the AO foundation.

References

  1. 1.
    Itsubo T, Murakami N, Uemura K, et al. Magnetic resonance imaging staging to evaluate the stability of capitellar osteochondritis dissecans lesions. Am J Sports Med. 2014;42(8):1972–7.CrossRefGoogle Scholar
  2. 2.
    Minami M, Nakashita K, Ishii S, et al. Twenty-five cases of osteochondritis dissecans of the elbow. Rinsho Seikei Geka. 1979;14(8):805–10.Google Scholar
  3. 3.
    van den Ende KIM, Keijsers R, van den Bekerom MPJ, Eygendaal D. Imaging of osteochondritis dissecans of the capitellum: X-ray, MRI or CT? Arthroscopy. 2017;Google Scholar
  4. 4.
    Claessen FM, van den Ende KI, Doornberg JN, Guitton TG, Eygendaal D, van den Bekerom MP. Osteochondritis dissecans of the humeral capitellum: reliability of four classification systems using radiographs and computed tomography. J Shoulder Elb Surg. 2015;24(10):1613–8.CrossRefGoogle Scholar
  5. 5.
    Takahara M, Mura N, Sasaki J, Harada M, Ogino T. Classification, treatment, and outcome of osteochondritis dissecans of the humeral capitellum. J Bone Joint Surg Am. 2007;89(6):1205–14.CrossRefGoogle Scholar

Copyright information

© ISAKOS 2020

Authors and Affiliations

  • Rens Bexkens
    • 1
    • 2
  • Nick F. J. Hilgersom
    • 1
    • 2
  • Denise Eygendaal
    • 1
    • 3
  1. 1.Orthopaedic SurgeryAcademic Medical Center, University of AmsterdamAmsterdamThe Netherlands
  2. 2.Orthopaedic SurgerySports Medicine Center, Massachusetts General Hospital, Harvard Medical SchoolBostonUSA
  3. 3.Orthopaedic SurgeryAmphia HospitalBredaThe Netherlands

Personalised recommendations