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Paper 38: Conservative Treatment of Osteochondritis Dissecans of the Humeral Capitellum among Young Baseball Players

OBJECTIVES: The goals of treatment of osteochondritis dissecans of the humeral capitellum (OCD) are morphological healing and early return to sports and these are often contradictive. The purpose of this study was to evaluate our conservative treatment of OCD and establish the appropriate treatment....

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Autores principales: Kida, Yoshikazu, Takatsuji, Kenta, Sukenari, Tsuyoshi, Furukawa, Ryuhei, Minami, Masataka, Morihara, Toru, Takahashi, Kenji, Kotoura, Yoshihiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9339855/
http://dx.doi.org/10.1177/2325967121S00602
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author Kida, Yoshikazu
Takatsuji, Kenta
Sukenari, Tsuyoshi
Furukawa, Ryuhei
Minami, Masataka
Morihara, Toru
Takahashi, Kenji
Kotoura, Yoshihiro
author_facet Kida, Yoshikazu
Takatsuji, Kenta
Sukenari, Tsuyoshi
Furukawa, Ryuhei
Minami, Masataka
Morihara, Toru
Takahashi, Kenji
Kotoura, Yoshihiro
author_sort Kida, Yoshikazu
collection PubMed
description OBJECTIVES: The goals of treatment of osteochondritis dissecans of the humeral capitellum (OCD) are morphological healing and early return to sports and these are often contradictive. The purpose of this study was to evaluate our conservative treatment of OCD and establish the appropriate treatment. METHODS: We retrospectively reviewed 206 patients with OCD who were treated conservatively at first visit our hospital and affiliated institutions from 2009 to 2019. Exclusion criteria were loss and less than 1 year follow-up. Mean age was 12.1 years (8-15). All patients were advised to stop or limit throwing and underwent physical therapy. Depending on the stage and healing process, at least, after waiting for the lateral wall of the capitellum to heal throwing was permitted to resume. Age at first visited, OCD Stage (Ⅰ; radiolucent area, Ⅱ; nondisplaced fragmentation, Ⅲ; loose body), clinical result (complete healing, partial healing, surgery required), and when to return to play were evaluated statistically. RESULTS: A total of 193 patients were enrolled. There were 115 patients that were stageⅠ with a mean age of 11.2 years, 63 patients that were stageⅡ with a mean age of 13.2 years, and 15 patients that were stageⅢ with a mean age of 14.1 years (Table 1), and these differences were statistically significant (p<0.01). Collectively, complete healing was observed in 70.4%, partial healing in 17.4%, surgery in 12.2% of stageⅠ, complete healing in 50.8%, partial healing in 12.7%, surgery in 36.5% of stageⅡ, and complete healing in 0%, partial healing in 26.7%, surgery in 73.3% of stageⅢ (Fig 1). Of the 47 patients who underwent surgery, arthroscopic debridement for OCD lesions was selected for 79%, osteochondral autograft transplantation was selected for 16%, and fixation was selected for 4% (Fig 2). The mean period of return to play was 8.6 months; < 6 months was 42%, 6 months- 1 year was 39%, 1 year-1.5 year was 16%, and 1.5%< was 3%. CONCLUSIONS: In this study, OCD lesions likely to heal when the OCD stage were early. Even if surgery was needed after failed conservative treatment, most of the patients were treated by arthroscopic debridement which was a relatively minimally invasive procedure. Conservative treatment of OCD was successful when the treatment is begun in early stage of the disease. UPLOAD-https://planion-client-files.s3.amazonaws.com/AOSSM/blobs/e5e18779-1cc0-4cc6-814b-a97204c6da85/1/file.pdf
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spelling pubmed-93398552022-08-02 Paper 38: Conservative Treatment of Osteochondritis Dissecans of the Humeral Capitellum among Young Baseball Players Kida, Yoshikazu Takatsuji, Kenta Sukenari, Tsuyoshi Furukawa, Ryuhei Minami, Masataka Morihara, Toru Takahashi, Kenji Kotoura, Yoshihiro Orthop J Sports Med Article OBJECTIVES: The goals of treatment of osteochondritis dissecans of the humeral capitellum (OCD) are morphological healing and early return to sports and these are often contradictive. The purpose of this study was to evaluate our conservative treatment of OCD and establish the appropriate treatment. METHODS: We retrospectively reviewed 206 patients with OCD who were treated conservatively at first visit our hospital and affiliated institutions from 2009 to 2019. Exclusion criteria were loss and less than 1 year follow-up. Mean age was 12.1 years (8-15). All patients were advised to stop or limit throwing and underwent physical therapy. Depending on the stage and healing process, at least, after waiting for the lateral wall of the capitellum to heal throwing was permitted to resume. Age at first visited, OCD Stage (Ⅰ; radiolucent area, Ⅱ; nondisplaced fragmentation, Ⅲ; loose body), clinical result (complete healing, partial healing, surgery required), and when to return to play were evaluated statistically. RESULTS: A total of 193 patients were enrolled. There were 115 patients that were stageⅠ with a mean age of 11.2 years, 63 patients that were stageⅡ with a mean age of 13.2 years, and 15 patients that were stageⅢ with a mean age of 14.1 years (Table 1), and these differences were statistically significant (p<0.01). Collectively, complete healing was observed in 70.4%, partial healing in 17.4%, surgery in 12.2% of stageⅠ, complete healing in 50.8%, partial healing in 12.7%, surgery in 36.5% of stageⅡ, and complete healing in 0%, partial healing in 26.7%, surgery in 73.3% of stageⅢ (Fig 1). Of the 47 patients who underwent surgery, arthroscopic debridement for OCD lesions was selected for 79%, osteochondral autograft transplantation was selected for 16%, and fixation was selected for 4% (Fig 2). The mean period of return to play was 8.6 months; < 6 months was 42%, 6 months- 1 year was 39%, 1 year-1.5 year was 16%, and 1.5%< was 3%. CONCLUSIONS: In this study, OCD lesions likely to heal when the OCD stage were early. Even if surgery was needed after failed conservative treatment, most of the patients were treated by arthroscopic debridement which was a relatively minimally invasive procedure. Conservative treatment of OCD was successful when the treatment is begun in early stage of the disease. UPLOAD-https://planion-client-files.s3.amazonaws.com/AOSSM/blobs/e5e18779-1cc0-4cc6-814b-a97204c6da85/1/file.pdf SAGE Publications 2022-07-28 /pmc/articles/PMC9339855/ http://dx.doi.org/10.1177/2325967121S00602 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc-nd/4.0/This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or build upon this article without the permission of the Author(s). For article reuse guidelines, please visit SAGE’s website at http://www.sagepub.com/journals-permissions.
spellingShingle Article
Kida, Yoshikazu
Takatsuji, Kenta
Sukenari, Tsuyoshi
Furukawa, Ryuhei
Minami, Masataka
Morihara, Toru
Takahashi, Kenji
Kotoura, Yoshihiro
Paper 38: Conservative Treatment of Osteochondritis Dissecans of the Humeral Capitellum among Young Baseball Players
title Paper 38: Conservative Treatment of Osteochondritis Dissecans of the Humeral Capitellum among Young Baseball Players
title_full Paper 38: Conservative Treatment of Osteochondritis Dissecans of the Humeral Capitellum among Young Baseball Players
title_fullStr Paper 38: Conservative Treatment of Osteochondritis Dissecans of the Humeral Capitellum among Young Baseball Players
title_full_unstemmed Paper 38: Conservative Treatment of Osteochondritis Dissecans of the Humeral Capitellum among Young Baseball Players
title_short Paper 38: Conservative Treatment of Osteochondritis Dissecans of the Humeral Capitellum among Young Baseball Players
title_sort paper 38: conservative treatment of osteochondritis dissecans of the humeral capitellum among young baseball players
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9339855/
http://dx.doi.org/10.1177/2325967121S00602
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