2017 ISAKOS Biennial Congress ePoster #414
Return To Play After Osteochondral Autograft Transplantation Of The Capitellum: A Systematic Review
Jacob M. Kirsch, MD, Boston, MA UNITED STATES
Jared Thomas, MD, Ann Arbor , MI UNITED STATES
Moin Khan, MD, MSc, FRCSC, Hamilton, ON CANADA
Whitney Townsend, MLIS, Ann Arbor, MI UNITED STATES
Jeffrey Lawton, MD, Ann Arbor , MI UNITED STATES
Asheesh Bedi, MD, Ann Arbor, MI UNITED STATES
University of Michigan, Ann Arbor, Michigan, UNITED STATES
FDA Status Cleared
Summary
Current best evidence based on this systematic review of available literature suggests that OAT is successful in treating advanced OCD lesions of the capitellum and returning athletes to high-level competition.
ePosters will be available shortly before Congress
Abstract
Purpose
To systematically review available literature evaluating the return to sport following osteochondral autograft transplantation (OAT) for osteochondritis dissecans (OCD) lesions of the capitellum.
Methods
A systematic review was conducted in duplicate of PubMed, EMBASE, Scopus, Web of Science, and CENTRAL databases, beginning from the database inception dates through July 2016, for all articles evaluating the return to play following OAT for OCD lesions of the capitellum. The k (kappa) statistic was used to examine interobserver agreement for study eligibility. A quality assessment was completed for all included studies. Interobserver agreement for methodologic quality assessment was calculated using the intraclass correlation coefficient (ICC). Patient demographics, osteochondral lesion and graft characteristics, time to return to competitive activity and the number of patients who returned to competitive activity were collected and evaluated.
Results
Seven articles were identified that met the inclusion criteria. All included studies were case series of moderate quality with a mean Methodological Index for Non-Randomized Studies score of 12/16. Agreement between reviewers in the assessment of study quality was good (ICC, 0.70; 95% confidence interval, 0.67 to 0.94). The k value for overall agreement between reviewers for the final eligibility decision was 0.86 (95% confidence interval, 0.67 to 1.00), indicating almost perfect agreement. Overall, 94% (119/126) of patients undergoing OAT for OCD lesions of the capitellum successfully returned to competitive sports. The average reported time for unrestricted return to athletic competition following OAT was 5.6 months (range, 3-14 months).
Conclusions
Current best evidence suggests that OAT is successful in treating advanced OCD lesions of the capitellum and returning athletes to high-level competition. The size and number of grafts used may influence the time to osseous healing, favoring the use of fewer large grafts, however current evidence supporting this is limited. Larger prospective studies with standardized outcome assessments are necessary to draw further conclusions regarding the return to play following OAT for OCD lesions of the capitellum.
Level of Evidence: Level IV, systematic review of Level IV studies.