Short-term results of arthroscopic micro-fracture and autologous osteochondralplasty for osteochondritis dissecans of elbow / 中华骨科杂志

ABSTRACT

Objective To evaluate the short-term results of arthroscopic treatment including micro-fractures and autologous osteochondralplasty for osteochondritis dissecans (OCD) of elbow.Methods Data of 30 OCD patients who were treated by arthroscopic micro-fracture or autologous osteochondralplasty from January 2012 to December 2014 were retrospectively analyzed.22 of them were followed-up for more than one year.Among them,there were 20 males and 2 females.All had OCD lesion on dominated side.The average age was 15 years old (range,12-19 years old).All patients suffered from pain and limitation on the range of motion at different level.Arthroscopic micro-fracture was performed if the diameter of the lesion was less than 1 cm,otherwise,autologous osteochondralplasty was performed.16 cases received arthroscopic micro-fracture and 6 cased received autologous osteochondralplasty.6 patients were athletes who received micro-fracture.16 patients were non-athletes and 10 of them received micro-fractures.The flexion-extension range of motion(ROM),Mayo elbow performance score (MEPS),visual analog scale for pain (VAS) were recorded preoperatively and at the final follow-up for comparison.Results Patients were followed up for 13 month on average (range,12-18 months) without any complications.All patients got improvement significantly with 100％ good or excellent rate.For patients receiving arthroscopic micro-fracture,the preoperative ROM,MEPS and VAS was 101.88°± 14.82°,64.38±4.79 and 5.13±1.09,which was improved to 114.38°±11.53°,88.75±8.06 and 0.88±1.02 respectively.There were significant differences between preoperative and postoperative ROM,MEPS and VAS.Among these 16 patients,13 were excellent and 3 were good.For 6 patients who received arthroscopic autologous osteochondralplasty,the preoperative ROM,MEPS and VAS was 105.00°± 11.83°,60.83±6.11 and 5.67±1.37,which was improved to 120.83°±6.11°,87.50±5.24 and 1.17±0.56 at the final follow up respectively.There were significant differences between preoperative and postoperative ROM,MEPS and VAS.Among these 6 patients,4 were excellent and 2 were good.Conclusion For elbow OCD,satisfied result can be expected by arthroscopic microfracture and autologous osteochondralplasty because both are effective procedures to improve the elbow function.