Arthroscopic management of osteochondritis dissecans of the elbow

Osteochondritis dissecans is a localized condition involving the articular surface, resulting in the separation of a segment of articular cartilage and subchondral bone. The most common site of osteochondritis dissecans of the elbow is the capitellum. Lesions have been reported in the trochlea, radial head, as well as the olecranon and olecranon fossa. Osteochondritis dissecans generally occurs in athletes ages 11 to 21 years who report a history of overuse. The osteonecrotic lesion involves only a segment of capitellum, located primarily at a central or anterolateral position. Appropriate treatment of this disorder remains controversial. Often treated with benign neglect, this condition is a potentially sport-ending injury for an athlete, with long-term sequelae of degenerative arthritis. The surgical option that we present and have studied is fragment excision with debridement of the necrotic lesion.