Academic Journal
Comprehensive Elbow Joint Morphology Changes in Surgically Treated Osteochondritis Dissecans of the Capitellum: Clinical Implications.
| Τίτλος: | Comprehensive Elbow Joint Morphology Changes in Surgically Treated Osteochondritis Dissecans of the Capitellum: Clinical Implications. |
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| Συγγραφείς: | Miyamura S; Department of Orthopaedic Surgery, The University of Osaka, Graduate School of Medicine, Suita, Osaka, Japan., Temporin K; Department of Orthopaedic Surgery, Japan Community Health Care Organization Osaka Hospital, Osaka, Osaka, Japan., Miyoshi Y; Department of Orthopaedic Surgery, Japan Community Health Care Organization Osaka Hospital, Osaka, Osaka, Japan., Shiode R; Department of Orthopaedic Surgery, The University of Osaka, Graduate School of Medicine, Suita, Osaka, Japan., Iwahashi T; Department of Orthopaedic Surgery, The University of Osaka, Graduate School of Medicine, Suita, Osaka, Japan., Okada S; Department of Orthopaedic Surgery, The University of Osaka, Graduate School of Medicine, Suita, Osaka, Japan., Oka K; Department of Orthopaedic Biomaterial Science, The University of Osaka, Graduate School of Medicine, Suita, Osaka, Japan., Tanaka H; Department of Sports Medical Science, The University of Osaka, Graduate School of Medicine, Suita, Osaka, Japan., Murase T; Department of Orthopaedic Surgery, Bell Land General Hospital, Sakai, Osaka, Japan., Shimada K; Department of Orthopaedic Surgery, Japan Community Health Care Organization Osaka Hospital, Osaka, Osaka, Japan. |
| Πηγή: | Orthopaedic journal of sports medicine [Orthop J Sports Med] 2025 May 26; Vol. 13 (5), pp. 23259671251339180. Date of Electronic Publication: 2025 May 26 (Print Publication: 2025). |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Sage on behalf of: The American Orthopaedic Society for Sports Medicine Country of Publication: United States NLM ID: 101620522 Publication Model: eCollection Cited Medium: Print ISSN: 2325-9671 (Print) Linking ISSN: 23259671 NLM ISO Abbreviation: Orthop J Sports Med Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: [Thousand Oaks, CA] : Sage on behalf of: The American Orthopaedic Society for Sports Medicine, [2013]- |
| Περίληψη: | Background: Capitellar osteochondritis dissecans (OCD) frequently results in radial head enlargement. However, due to the elbow joint's complex anatomy, deformities likely extend beyond just the radial head. Hypothesis/purpose: It was hypothesized that in patients with OCD treated with surgery, imbalances in bone morphology during growth would affect the entire joint, leading to postoperative clinical symptoms. The purpose of this study was to test this hypothesis through a 3-dimensional evaluation of morphological changes. Study Design: Cross-sectional study; Level of evidence, 3. Methods: After retrospective identification, this study enrolled 47 patients who had undergone surgery, with a mean postoperative follow-up of 6.8 years. After in-person evaluation and bilateral computed tomography scanning, 3-dimensional bone models of the affected and contralateral elbows were created. The bone morphology of the radial head, the distal humerus, and the proximal ulna at the anatomic points were evaluated and compared between affected and contralateral sides. These measurements were correlated with clinical symptoms, and risk factors for these changes were identified. Results: The mean age at examination was 20.6 ± 3.3 years and at surgery was 13.9 ± 1.3 years, with a mean follow-up of 6.8 ± 3.2 years. In the radial head, morphological enlargement was observed for radioulnar diameter (26.3 ± 1.9 vs 22.9 ± 1.5 mm; P < .001) and dorsovolar diameter (26.5 ± 1.9 vs 24.2 ± 1.5 mm; P < .001). In the humeral trochlea, enlargement was noted at the lateral trochlea (28.2 ± 1.7 vs 25.0 ± 1.3 mm; P < .001), trochlear groove (20.4 ± 1.7 vs 17.9 ± 1.6 mm; P < .001), and medial trochlea (30.5 ± 2.1 vs 25.5 ± 1.6 mm; P < .001) as well as the ulnar trochlear notch (28.2 ± 1.7 vs 25.0 ± 1.3 mm; P < .001). Restricted elbow flexion was associated with radial head enlargement in radioulnar and dorsovolar diameters (R = 0.60, P < .001; R = 0.44, P = .002). Lesion size was identified as a risk factor for these changes (odds ratio [OR], 1.36; P = .019), as was development of OCD during skeletal growth (OR, 0.82; P = .006). Conclusion: Over mid- to long-term follow-up, the entire elbow joint underwent cylindrical-like morphological changes, leading to restricted motion. Enlargement typically developed during skeletal growth, with larger lesions resulting in more severe enlargement. Awareness of these natural postoperative changes is crucial, and it is clinically important to provide appropriate treatment during skeletal growth when treating OCD. (© The Author(s) 2025.) |
| Competing Interests: | One or more of the authors has declared the following potential conflict of interest or source of funding: S.M. reports personal fees from the Japan Society for the Promotion of Science (Grants-in-Aid for Scientific Research KAKENHI) (Grant No. 24K19578 and 22H03199) and the Japanese Orthopaedic Association (JOA–Subsidized Science Project Research) (Grant No. 2023–2). AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto. Ethical approval for this study was obtained from Japan Community Health Care Organization, Osaka Hospital (Approval No. 2021-015). |
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| Contributed Indexing: | Keywords: capitellum; enlargement; morphology; osteochondritis dissecans (OCD); risk factor |
| Entry Date(s): | Date Created: 20250528 Latest Revision: 20250530 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC12106974 |
| DOI: | 10.1177/23259671251339180 |
| PMID: | 40433311 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 2325-9671 |
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| DOI: | 10.1177/23259671251339180 |