Radiographic analysis of cartilage surface restoration in patients with pediatric capitellar osteochondritis dissecans lesions following osteochondral autologous transplantation.

BACKGROUND

Osteochondral autologous transplant (OAT) is an option in the treatment of pediatric capitellar osteochondritis dissecans (OCD). However, quantifying the improvement in the area of OCD defects contributing to the articular surface after an OAT procedure has not been well documented. The purpose of this study was to use magnetic resonance imaging (MRI) to evaluate changes in the defect area of capitellar OCD lesions in pediatric patients following an OAT procedure using a lateral femoral condyle autograft.

METHODS

Pediatric patients with capitellar OCD lesions underwent an OAT from the lateral femoral condyle to the involved capitellum. MRI was obtained preoperatively, 3 months postoperatively, and 12 months postoperatively. Sagittal image slices of the capitellum were analyzed to measure the percentage area of articular cartilage defect compared with a best-fit circle simulating the ideal profile of the capitellum.

RESULTS

Twelve patients met the inclusion criteria for this study. Preoperatively, the average percentage area of defect within each capitellar OCD lesion (compared to the ideal profile) was 16%. At 3 months postoperatively, the average area defect significantly improved to 3% (P < .01) compared to preoperative imaging. One patient (8.3%) had complete filling of their cartilage defect, and 10 patients (83%) had ≤3% area of defect. One patient (8.3%) had subsidence of articular cartilage between their postoperative imaging at 3 months and 12 months. Despite this, there was no significant change in defect area between 3 months and 12 months postoperatively (P = .07).

CONCLUSION

This radiographic analysis of area restoration following an OAT procedure for pediatric capitellar OCD lesions demonstrates a significant decrease in defect area on the articular surface in postoperative MRI. This study provides further support for the utilization of an OAT procedure for the management of pediatric capitellar OCD lesions.