APEX Elbow Mastering Surgical Techniques for Clinical Success-OCD Elbow

Video Transcription

Video Summary

The speaker discusses treatment of capitellar osteochondritis dissecans (OCD) and related elbow cartilage/bone pathology, emphasizing that elbow fusion has no reliably “good” position and is undesirable. They highlight Japan’s use of ultrasound screening to detect very early OCD changes in young athletes and successfully treat them with rest, noting nonoperative management works well for stage 1–2 lesions when confirmed by MRI and activity is stopped.<br /><br />The talk favors arthroscopy as first-line for many lesions: debridement and microfracture can yield good mid- to long-term outcomes, with CT evidence that defects may fill in over time. Technical pearls include using a distal ulnar portal to avoid “sword fighting” and improve access while minimizing destabilization. OATs (osteochondral autograft transfer) can work but may fail if plugs are proud or poorly placed; donor-site knee morbidity is a concern. Post-op rehab: early active motion, but no strengthening for 6 weeks and no ballistic loading for ~4 months. Biologics are discussed but not routinely used.

Asset Caption

Moderator: Scott P. Steinmann, M.D.

Keywords

capitellar osteochondritis dissecans

elbow arthroscopy microfracture

ultrasound screening young athletes

nonoperative management rest MRI staging

osteochondral autograft transfer OAT donor-site morbidity