English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

Hypothesis: Advanced lesion of osteochondritis dissecans (OCD) of the elbow should be treated surgically by the protocol “arthroscopic debridement with or without reconstruction according to the lesion size.” Materials and Methods: In total, 131 advanced OCD patients (International Cartilage Research Society [ICRS] OCD III or IV) were treated and followed more than 18 months (18-140 with mean of 36 months). Most of the patients were young boys such as baseball players, gymnasts, boxers, and judo athletes. The elbow OCD lesions were evaluated by preoperative x-ray, computed tomography (CT), or magnetic resonance imaging (MRI), and classified into 3 types by lesion size: small (articular lesion diameter [ALD] smaller than 10 mm), medium (ALD 10-15 mm), and large (ALD larger than 15 mm). For a small lesion, it was shaved arthroscopically (AS, n = 32). For a medium lesion, it was reconstructed by a local anconeus muscle–pedicled bone graft (BG) covered with periosteum flap (n = 16). For a large lesion, it was completely shaved and reconstructed by osteochondral autograft transplantation (OAT) from the patient’s knee (n = 16) or reconstructed by cylindrical costal-rib osteochondral autograft (CCOA, n = 67). Totally, 159 patients were operated in 1998 to 2014 and 131 were enrolled in this follow-up study (follow-up rate, 82.4%). Clinical findings (pain, range of motion [ROM], and physical activity) were reviewed. Timmerman and Andrews score was evaluated before and after surgery. Results: Overall Findings—Preoperative symptoms were pain, elbow catching in their activities, and limitation of motion. Their sports activities were limited. Pain and catching were improved after surgery. ROM (flexion/extension) was 126/–14 preoperatively and improved to 134/–4 at final follow-up. More than 90% of the patients returned to their former activities. Timmerman and Andrews score was 130 preoperatively and improved to 186 at final follow-up. Each procedure showed equally good end results (ROM: preoperative and at follow-up, 125/–9 improved to 132/–4 in AS, 128/–13 improved to 135/1 in BG, 125/–11 improved to 134/–5 in OAT, and 126/–17 improved to 134/–4 in CCOA; Timmerman and Andrews: 144 improved to 185 in AS, 141 improved to 193 in BG, 134 improved to 180 in OAT, and 121 improved to 186 in CCOA). Twenty-one additional minor surgeries such as hardware removal or arthroscopic removal of free bodies were performed in 21 cases in the follow-up. Conclusions: Complete resection of the damaged articular lesion is recommended for the advanced OCD of the elbow. For a large articular lesion, several types of reconstruction were possible. This protocol will serve good functional recovery to some extent for the damaged young athletes’ elbow.

Surgical Treatment Protocol for the Advanced Articular Lesion of Osteochondritis Dissecans of the Elbow