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J Hand Surg Am 2021 Apr 27. Epub 2021 Apr 27.

Department of Orthopedic Surgery, Washington University, St. Louis, MO. Electronic address:

Purpose: Outcome measures that lack sensitivity for the detection of clinical changes early after surgery for capitellar osteochondritis dissecans (OCD) make it difficult to determine the optimal treatment for these defects. We sought to evaluate the early responsiveness of patient-reported outcomes measurement information system (PROMIS) scores in a cohort of patients operatively treated for capitellar OCD.

Methods: Four PROMIS questionnaires (mobility, upper extremity [UE], pain interference, and peer relations) were electronically administered to patients treated for capitellar OCD at a single tertiary academic medical center between January 1, 2015, and July 1, 2018. Read More

Orthop J Sports Med 2021 Apr 7;9(4):23259671211007741. Epub 2021 Apr 7.

Department of Orthopaedic Surgery, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan.

Background: Osteochondritis dissecans (OCD) of the humeral capitellum occurs in adolescent overhead athletes, and medial epicondyle (ME) lesions are also common in this population.

Purpose: To evaluate the association between elbow OCD and ME lesions in adolescent baseball players.

Study Design: Cross-sectional study; Level of evidence, 3. Read More

J Hand Surg Am 2021 Jun 29;46(6):454-461. Epub 2021 Mar 29.

Department of Orthopedic Surgery, Washington University School of Medicine, St Louis, MO. Electronic address:

Purpose: Magnetic resonance imaging (MRI) is a helpful tool in the evaluation of osteochondritis dissecans (OCD) of the humeral capitellum. The relationship between MRI appearance and clinically relevant intraoperative findings is incompletely understood. The goal of this study was to evaluate capitellar OCD lesions via preoperative MRI and to determine its accuracy in predicting lesion characteristics including lesion size and capitellar lateral wall integrity. Read More

JSES Int 2021 Mar 16;5(2):307-313. Epub 2020 Dec 16.

Department of Orthopaedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.

Background: Repetitive mechanical stress on the elbow joint during throwing is a cause of ulnar collateral ligament dysfunction that may increase the compressive force on the humeral capitellum. This study aimed to examine the effects of ulnar collateral ligament material properties on the humeral capitellum under valgus stress using the finite element method.

Methods: Computed tomography data of the dominant elbow of five healthy adults were used to create finite element models. Read More

JSES Int 2021 Jan 29;5(1):35-41. Epub 2020 Oct 29.

Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.

Background And Hypothesis: It is generally considered that fragment fixation with bone pegs (FFBP) for osteochondritis dissecans (OCD) of the humeral capitellum can be indicated for stages I and II according to the International Cartilage Repair Society (ICRS) classification of OCD and it is difficult to obtain complete bone union for advanced lesions. However, the clinical and radiologic results of FFBP with cancellous bone graft for ICRS-OCD stage III with lateral wall involvement have not been described in detail. Good bone union can be achieved with the lateral wall fragment of the capitellum by FFBP in combination with refreshing the sclerotic surface at the base of the lesion and cancellous bone grafting even in ICRS-OCD stage III lesions. Read More

J Shoulder Elbow Surg 2021 Jan 21. Epub 2021 Jan 21.

Department of Orthopedics, Washington University in St. Louis, St. Louis, MO, USA. Electronic address:

Background: Patient-Reported Outcomes Measurement Information System (PROMIS) scores have not previously been used to measure long-term outcomes in operatively treated capitellar osteochondritis dissecans (OCD) patients. The aims of our study were to (1) assess patients' long-term outcomes using PROMIS scores, (2) compare the performance of PROMIS with other validated elbow legacy metrics, and (3) evaluate ceiling and floor effects in these outcome measures in patients undergoing surgical treatment for capitellar OCD.

Methods: We evaluated demographic characteristics, procedure details, preoperative PROMIS scores, and associated sports information in surgically treated pediatric capitellar OCD patients. Read More

Am J Sports Med 2021 02 15;49(2):353-358. Epub 2020 Dec 15.

Department of Orthopedic Sports Medicine, Yokohama Minami Kyosai Hospital, Kanagawa, Japan.

Background: Osteochondritis dissecans of the humeral capitellum (capitellar OCD) is a common injury among youth baseball players, but there are only a few studies that report on return to play with nonoperative treatment.

Purpose: To evaluate the medial elbow joint laxity under valgus stress and radiocapitellar congruity in patients with capitellar OCD and evaluate their relationship to predicting rehabilitation outcome.

Study Design: Case-control study; Level of evidence, 3. Read More

Arthrosc Tech 2020 Nov 20;9(11):e1727-e1730. Epub 2020 Nov 20.

Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, Texas, U.S.A.

Chondral and osteochondral lesions of the humeral capitellum, most notably osteochondritis dissecans, most commonly present in adolescent baseball players and gymnasts. A variety of surgical techniques can be used to address these lesions. Osteochondral autograft transfer has recently shown superior rates of return to sport. Read More

Orthop J Sports Med 2020 Mar 31;8(3):2325967120914656. Epub 2020 Mar 31.

[This corrects the article DOI: 10.1177/2325967119876247.]. Read More

Am J Sports Med 2020 03 13;48(4):966-973. Epub 2020 Feb 13.

Department of Orthopedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Background: Autologous osteochondral grafting (OG) is an option in the treatment of capitellar osteochondritis dissecans (COCD). However, radiographic healing after this procedure has not been well documented.

Purpose: To develop a magnetic resonance imaging (MRI)-based scoring system specific for evaluating healing after single-plug OG in COCD and to evaluate correlation between radiographic healing and early clinical outcomes. Read More

Orthop Clin North Am 2020 Jan 25;51(1):97-108. Epub 2019 Sep 25.

Fondren Orthopaedic Group, TERFSES Shoulder and Elbow Fellowship, Texas Orthopedic Hospital, 7401 South Main Street, Houston, TX 77030, USA.

Osteochondritis dissecans (OCD) of the capitellum is a relatively rare condition, with a higher incidence in adolescents who participate in repetitive overhead sports. The surgical treatment approach for this uncommon problem has varied from microfracture, loose body removal, abrasion chrondroplasty, lesion fixation, osteochondral allograft transplantation surgery, and osteochondral autologous transplantation surgery. The purpose of this study is to present the authors' preferred surgical technique for the treatment of unstable OCD lesions of the capitellum with osteochondral autologous transplantation surgery using autograft from the ipsilateral knee. Read More

Arthroscopy 2019 11;35(11):3025-3032

Department of Orthopaedic Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands; Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands.

Purpose: To compare the histologic features of the cartilage from the capitellum with 2 proposed alternative donor sites from the ipsilateral elbow in the treatment of capitellar osteochondritis dissecans (OCD): the nonarticulating part of the radial head and the nonarticulating lateral side of the olecranon tip.

Methods: Ten human cadaveric elbow specimens with macroscopically normal articular surfaces were used to obtain 5-mm osteochondral grafts: 10 from the capitellum (60° anteriorly relative to the humeral shaft), 10 from the radial head (nonarticulating part at 80°), and 4 from the olecranon (lateral side of the olecranon tip). Grafts were fixated in formalin (4% formaldehyde), decalcified, and processed into standard 8-μm-thick hematoxylin and eosin-and Toluidine Blue-stained sections. Read More

Orthop J Sports Med 2019 Oct 24;7(10):2325967119876247. Epub 2019 Oct 24.

Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.

Background: Even in patients with an open capitellar physis, nonsurgical treatment for advanced-stage osteochondritis dissecans (OCD) of the capitellum often yields poor outcomes. However, surgical methods for such patients are controversial. At our institution, we have consistently performed closed-wedge osteotomy of the distal humerus to treat advanced-stage OCD of the capitellum, regardless of the OCD grade or condition of the capitellar physis. Read More

Am J Sports Med 2019 09 26;47(11):2691-2698. Epub 2019 Jul 26.

Keiyu Orthopaedic Hospital, Tatebayashi, Japan.

Background: Osteochondritis dissecans of the humeral capitellum (capitellar OCD) is a common injury among adolescent throwing athletes. Some younger patients with incomplete maturity of the epiphysis and early-stage capitellar OCD are good candidates for nonoperative treatment. However, during initial examination, predicting the need for surgical treatment in patients with capitellar OCD is difficult. Read More

J Shoulder Elbow Surg 2019 Sep 17;28(9):e313-e320. Epub 2019 Jul 17.

Niigata Hand Surgery Foundation Hospital, Seiromachi, Niigata, Japan.

Background: Various surgical methods are used for osteochondritis dissecans of the capitellum; however, we have consistently performed a closed-wedge osteotomy of the lateral humeral condyle since 1983. The purpose of this study is to clarify the long-term results of closed-wedge osteotomy for osteochondritis dissecans of the capitellum.

Methods: Seventy-seven elbows with all lesion types of osteochondritis dissecans of the capitellum were treated with closed-wedge osteotomy. Read More

Knee Surg Sports Traumatol Arthrosc 2019 Oct 24;27(10):3291-3296. Epub 2019 Jun 24.

Università Cattolica del Sacro Cuore-Fondazione Policlinico Gemelli, Largo Agostino Gemelli 8, 00168, Rome, RM, Italy.

Purpose: The primary outcomes are the evaluation and quantification of pain relief and improvement in range of motion after OAT in OCD. The secondary outcomes are: resuming of sport activities, evaluation of the ADL recovery rate and subjective evaluation of the quality of life improvement.

Methods: Nine patients, affected by an unstable and non-acute OCD lesion of the capitulum humeri, have been treated by the same surgeon. Read More

Shoulder Elbow 2019 Apr 13;11(2):129-136. Epub 2018 Feb 13.

Upper Limb Unit, Amphia Hospital, Breda, The Netherlands.

Background: Diagnosing capitellar osteochondritis dissecans (OCD) can be difficult, causing delay in treating young athletes. The main aim of this retrospective diagnostic study was to determine which radiological technique is preferred to identify and classify elbow OCD.

Methods: We identified young patients who underwent elbow arthroscopy because of symptomatic OCD. Read More

JSES Open Access 2018 Jul 10;2(2):126-128. Epub 2018 Apr 10.

Orthopedic Department, Japanese Red Cross Hospital Nagoya Daiichi, Nagoya, Japan.

Curr Rev Musculoskelet Med 2019 Mar;12(1):1-12

Department of Orthopedic Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA.

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. Read More

J Shoulder Elbow Surg 2018 Oct 22;27(10):1762-1769. Epub 2018 Jun 22.

Hospital for Special Surgery, New York, NY, USA. Electronic address:

Background: The location of capitellar osteochondritis dissecans (OCD) lesions in the sagittal plane guides the surgical approach used for autologous osteochondral transplantation. We sought to compare the capitellar region accessible for orthogonal graft placement through 3 approaches: (1) posterior anconeus-split approach; (2) lateral approach with lateral collateral ligament (LCL) preservation (LCL-preserving lateral approach); and (3) lateral approach with LCL release (LCL-sacrificing lateral approach).

Methods: The 3 approaches were sequentially performed on 9 cadaveric elbows: posterior anconeus-split approach, LCL-preserving lateral approach, and LCL-releasing lateral approach. Read More

J Shoulder Elbow Surg 2018 Sep 22;27(9):1642-1649. Epub 2018 Jun 22.

Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan.

Background: Although the pronator teres muscle, a major dynamic stabilizer of elbow valgus stress during throwing, frequently presents stiffness, its relationship with elbow injuries in youth baseball players is unknown. This study investigated the relationship between the elasticity of the pronator teres muscle and elbow injuries in youth baseball players.

Methods: The strain ratio (SR) of 15 individuals with osteochondritis dissecans of the humeral capitellum (OCD group), 67 individuals with medial epicondylar fragmentation (medial injury group), and 115 healthy individuals (control group) was measured as the index of the elasticity of the pronator teres muscle using ultrasound strain elastography. Read More

J Bone Joint Surg Am 2018 06;100(11):e80

J Bone Joint Surg Am 2018 Jun;100(11):903-913

Clinical Research Center, International University of Health and Welfare, Tokyo, Japan.

Background: Costal osteochondral grafting is a technique to achieve anatomical and biological repair of articular defects. Some small series of clinical applications of this procedure for advanced osteochondritis dissecans of the humeral capitellum, with short-term follow-up, have been reported; however, longer-term outcomes remain unclear. The purpose of this study was to clarify longer-term clinical outcomes of costal osteochondral autografts in the treatment of advanced osteochondritis dissecans of the humeral capitellum. Read More

Am J Sports Med 2018 07 8;46(8):1943-1951. Epub 2018 May 8.

Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan.

Background: Autologous osteochondral mosaicplasty (ie, mosaicplasty) results in satisfactory clinical outcomes and reliable return to play for patients with large or unstable lesions due to osteochondritis dissecans (OCD) of the humeral capitellum. However, the association between the healing of the reconstructed cartilage and clinical outcomes remains unclear.

Purpose: To evaluate the efficacy of mosaicplasty in teenage athletes through use of clinical scores and imaging. Read More

Orthop J Sports Med 2018 Apr 18;6(4):2325967118769059. Epub 2018 Apr 18.

Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts, USA.

Background: Osteochondritis dissecans (OCD) of the elbow has almost exclusively been described in the humeral capitellum, with only a small number of reports describing secondary osteochondral changes in the radial head.

Hypothesis: The authors hypothesized that concomitant radial head lesions (RHLs) would be seen with capitellar OCD and that patients with RHLs would present with more advanced capitellar OCD lesions and would respond better to procedures restoring articular congruity.

Study Design: Cohort study; Level of evidence, 2. Read More

J Hand Surg Am 2018 Nov 17;43(11):1039.e1-1039.e7. Epub 2018 Apr 17.

Hospital for Special Surgery, New York, NY. Electronic address:

Purpose: The location of capitellar osteochondritis dissecans (OCD) lesions in the sagittal plane guides the surgical approach, and lesion location in the coronal plane influences surgical management. Although most lesions have been reported to occur between 4 o'clock and 4:30 (120° to 135° anterior to the humerus), some lesions are located elsewhere in the capitellum. The primary aim was to define the region of the capitellum affected by OCD lesions using a novel clock-face localization system. Read More

Int Orthop 2018 05 15;42(5):1201. Epub 2018 Mar 15.

Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands.

J Shoulder Elbow Surg 2018 May 21;27(5):923-930. Epub 2018 Feb 21.

Department of Orthopaedic Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.

Background: Predictive factors for the development of osteoarthritis in adolescent osteochondritis dissecans (OCD) of the humeral capitellum remain unclear. The objectives of this study were to assess subchondral bone density in the radial head fovea of patients with OCD and to evaluate stress distribution in the radiocapitellar joint. The relationship between radiologic classification and stress distribution, according to multivariate ordinal regression analysis, was also investigated. Read More

Int Orthop 2018 03 18;42(3):601-607. Epub 2018 Jan 18.

Sports Medicine Service, Beijing Jishuitan Hospital, No.31, Xin Jie Kou Dong Jie Street, Xi Cheng District, Beijing, China.

Purpose: We present a systematic review of the recent literatures regarding the arthroscopic and open technique in fragment fixation for osteochondritis dissecans (OCD) of the humeral capitellum and an analysis of the subjective and objective outcomes between these two procedures.

Methods: PubMed and EMBASE were reviewed for suitable articles relating to fragment fixation for OCD, both open and arthroscopic. We included all studies reporting on the clinical outcomes of these two procedures that were published in the English language. Read More

J Orthop Sci 2018 Mar 22;23(2):213-219. Epub 2017 Dec 22.

Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine, Yamagata, Japan.

Osteochondritis dissecans (OCD) of the humeral capitellum is a critical elbow injury in adolescent overhead throwing athletes. However, its etiology remains unknown. Medical examinations using ultrasonography found that the prevalence of capitellar OCD among adolescent baseball players was approximately from 1% to 3%. Read More