2019 ISAKOS Biennial Congress ePoster #509
The Osseous Morphologic Change After the Mosaicplasty for the Advanced Osteochondritis Dissecans of the Humeral Capitellum with the Damaged Lateral Wall
Kenichi Matsumura, MD, Osaka, Osaka JAPAN
Kazuhiro Uenaka, MD, PhD, Otsu, Shiga JAPAN
Taizo Shirouchi, MD, ATC, Tennoji-Ku, Osaka, Osaka JAPAN
Fujiwara Kei, MD, Osaka, Osaka JAPAN
Tetsuya Yamazaki, MD, Yokohama, Kanagawa JAPAN
Masashi Honjo, MD, PhD, Osaka, Osaka JAPAN
Shinji Imai, MD, PhD, Otsu, Shiga JAPAN
Tane General Hospital, Osaka, Osaka, JAPAN
FDA Status Cleared
After the mosaic pasty for the osteochondritis of the humeral capitellum,he osseous morphologic changes had advanced.
Autologous osteochondral mosaicplasty (mosaicplasty) for the advanced osteochondritis dissecans of the humeral capitellum (capitellum OCD) has recently been known as effective procedure. However, when the capitellum OCD include the damaged lateral wall, this completely reconstruction will be very difficult and the occurrence of the osteoarthritis in elbow be predicted. The aim of this study is to investigate the osseous morphological change with using X-ray after mosaicplasty for the advanced capitellum OCD with the damaged lateral wall.
Fourteen baseball players whose mean age were 13 years old with the advanced capitellum OCD with the deficit of the lateral wall were treated with the mosaicplasty. We retrospectively analyzed these patients. The mean follow-up period was 17.3months. With X-ray, we calculated carrying angle, radial head index, lateral shift of the radial head, anterior shift of the radial head, humeral trochea width, olecranon trochea width, coronoid process degree for ulnar axis and olecranon degree for ulnar axis, which we investigated as the osseous morphologic evaluation. We recorded elbow range of motion, ability to return to sports, and knee pain.
Radial head index, lateral shift of radial head, humeral trochea width, olecranon trochea width, coronoid process degree and olecranon degree had increased after the mosaic plasty. All patients returned to sports. Eleven patients had no complaint. Mean elbow motion was 130.8°of flexion with 12.7°of extention loss preoperatively and improved to 134.4°of flexion with 7.4°of extention loss on the latest follow-up. No patient had knee pain.
The mosaic plasty was useful for the treatment of the advanced capitellum OCD with the damaged lateral wall. However, the osseous morphologic changes had advanced. We should recognize the limitation of this procedure and follow these patients for a long-term.