Fresh osteochondral allograft transplantation for osteochondritis dissecans of the capitellum in baseball players

J Shoulder Elbow Surg. 2016 Nov;25(11):1839-1847. doi: 10.1016/j.jse.2016.08.006.


Background: Osteochondritis dissecans (OCD) of the capitellum is a rare yet debilitating injury seen in young athletes. This is the first report in the literature describing fresh osteochondral allograft transplantation (FOCAT) to treat OCD of the capitellum.

Methods: Nine male baseball players (mean age, 15.3; range, 14-18 years), with OCD of the capitellum were treated with FOCAT. There were 6 pitchers and 3 position players. A ligament-sparing, mini-open approach was used. A fresh femoral hemicondyle was used as a donor source. Of the 9 patients, 7 required 1 plug and 2 required 2 plugs. The average plug diameter was 11 mm (range, 8-18 mm). Five plugs were press fit, and 4 required additional fixation. Clinical outcomes were evaluated at a mean follow-up of 48.4 months (range, 11-90 months). Preoperative and postoperative outcome scores were calculated using the paired t test.

Results: The Mayo Elbow Performance score improved from an average 57.8 to 98.9 (P < .01). The Oxford Elbow Score improved from 22.4 to 44.8 (P < .01). The Disabilities of the Arm, Shoulder and Hand score improved from 35.2 to 5.4 (P < .01). The visual analog scale score improved from 7.8 to 0.5 (P < .01). The Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow score improved from 32.6 to 82.5 (P < .01). All patients returned to throwing and were still active in their sport or played at least 2 years of baseball before leaving the sport unrelated to the elbow.

Conclusions: FOCAT for OCD of the capitellum in properly selected cases is a viable treatment with significant functional improvement and pain reduction in throwers.

Keywords: Osteochondritis dissecans; baseball; capitellum; elbow; osteochondral allograft transplantation; thrower.

MeSH terms

  • Adolescent
  • Allografts
  • Baseball / injuries*
  • Cartilage / transplantation*
  • Disability Evaluation
  • Femur / transplantation*
  • Follow-Up Studies
  • Humans
  • Male
  • Osteochondritis Dissecans / surgery*
  • Retrospective Studies
  • Return to Sport