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Current Reviews in Musculoskeletal Medicine
Published in: Current Reviews in Musculoskeletal Medicine 1/2019

01-03-2019 | Wound Debridement | Injuries in Overhead Athletes (J Dines and C Camp, section editors)

Osteochondritis dissecans lesions of the capitellum in overhead athletes: a review of current evidence and proposed treatment algorithm

Authors: Anthony L. Logli, Christopher D. Bernard, Shawn W. O’Driscoll, Joaquin Sanchez-Sotelo, Mark E. Morrey, Aaron J. Krych, Christopher L. Camp

Published in: Current Reviews in Musculoskeletal Medicine | Issue 1/2019

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Abstract

Purpose of the Review

To review the most recent literature on osteochondritis dissecans (OCD) lesions of the capitellum in overhead athletes and describe a treatment algorithm based on current best evidence and surgeon experience.

Recent Findings

Recent research has included larger cohort studies with longer follow-up as well as quality systematic reviews and meta-analyses. These studies have focused on understanding how lesion characteristics such as size, location, and appearance on advanced imaging can predict treatment success. Current literature continues to support nonoperative management for stable lesions. Operative intervention is generally required for unstable lesions and treatment strategies are largely dictated by lesion size and location: debridement or reparative techniques for small lesions while larger lesions or those in high-stress locations are better served by bone and/or cartilage restoration procedures. There has been a rising interest in the use of allograft materials and cell-based therapies.

Summary

Overhead athletes are uniquely predisposed to capitellar OCD due to the nature of forces applied to the radiocapitellar joint during repeated activity in the overhead position. Despite improvements in operative techniques, successful use of alternative graft materials, and a better understanding of how lesion characteristics influence results, there is still much to learn about this challenging disorder. Future research should focus on comparing operative techniques, refining their indications, and further developing a reliable treatment algorithm that best serves the overhead athlete.
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Metadata
Title
Osteochondritis dissecans lesions of the capitellum in overhead athletes: a review of current evidence and proposed treatment algorithm
Authors
Anthony L. Logli
Christopher D. Bernard
Shawn W. O’Driscoll
Joaquin Sanchez-Sotelo
Mark E. Morrey
Aaron J. Krych
Christopher L. Camp
Publication date
01-03-2019
Publisher
Springer US
Published in
Current Reviews in Musculoskeletal Medicine / Issue 1/2019
Electronic ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-019-09528-8

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