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Autologous Osteochondral Mosaicplasty for Osteochondritis Dissecans of the Elbow in Teenage Athletes

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タイトル: Autologous Osteochondral Mosaicplasty for Osteochondritis Dissecans of the Elbow in Teenage Athletes
著者: Iwasaki, Norimasa 著作を一覧する
Kato, Hiroyuki 著作を一覧する
Ishikawa, Jyunichi 著作を一覧する
Masuko, Tatsuya 著作を一覧する
Funakoshi, Tadanao 著作を一覧する
Minami, Akio 著作を一覧する
発行日: 2009年10月 1日
出版者: Journal of Bone and Joint Surgery
誌名: The Journal of Bone and Joint Surgery
巻: 91
号: 10
開始ページ: 2359
終了ページ: 2366
出版社 DOI: 10.2106/JBJS.H.01266
抄録: Background: Although autologous osteochondral mosaicplasty is widely used as a procedure for osteochondritis dissecans lesions, the effectiveness of this procedure in elbow lesions remains unclear. Our aim was to clarify the surgical efficacy of mosaicplasty for teenage athletes with advanced lesions of capitellar osteochondritis dissecans. Methods: From 2001 to 2006, nineteen teenage male patients who were competitive athletes and had advanced lesions of capitellar osteochondritis dissecans underwent mosaicplasties. The mean age of the patients was 14.2 years. The surgical technique involved obtaining small-sized cylindrical osteochondral grafts with a mean diameter of 3.5 mm from the lateral periphery of the femoral condyle at the level of the patellofemoral joint and transplanting the grafts (mean, 3.3 grafts) to prepared osteochondral defects. The patients were evaluated clinically and radiographically at a mean of forty-five months after surgery. Results: Eighteen patients were free from elbow pain, and one had mild pain occasionally. The mean total arc of elbow motion and standard deviation increased significantly from 112°± 17°preoperatively to 128°± 12°postoperatively (p < 0.005). The mean clinical score described by Timmerman and Andrews (with a maximum of 200 points) improved significantly from 131 ± 23 points preoperatively to 191 ± 15 points postoperatively (p < 0.0001). All patients except one had an excellent or good clinical result. All donor knees were graded as excellent on the basis of the Lysholm knee scoring system. All patients except two returned to a competitive level of the sport they had previously played. Neither loose-body formation nor secondary osteoarthritic changes were found in any patient. Conclusions: The current midterm results indicate that mosaicplasty can provide satisfactory clinical outcomes for teenage athletes with advanced capitellar osteochondritis dissecans lesions. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.
Rights: Copyright © 2009 The Journal of Bone and Joint Surgery, Inc.
資料タイプ: article
出現コレクション:雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

提供者: 岩崎 倫政


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