Arthroscopic surgery in athletes with osteochondritis dissecans of the elbow

Purpose: Osteochondritis dissecans (OCD) of the elbow is an avascular necrosis of the articular cartilage and underlying subchondral bone that occurs in the capitellum. The purpose of this review is to evaluate the results of arthroscopic surgery, including debridement, fragment fixation, micro-fracturing, and osteochondral autografting, in athletes with OCD of the elbow.

Methods: We searched PubMed, EMBASE, and the Cochrane library using the following main terms: osteochondritis dissecans, elbow, and surgical intervention. The 9 selected articles were criticized by use of a quality assessment tool derived from the Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group.

Results: The included studies had low methodologic quality and showed satisfactory results regarding pain, return to sports, and elbow function.

Conclusions: This review suggests that surgical treatment must be contemplated after a period of unsuccessful conservative therapy for athletes with OCD. Nevertheless, larger studies with enhanced methodologic quality and longer follow-up should be performed to support this conclusion.

Level of evidence: Level III, systematic review of Level IV studies.