Treatment and Early Outcomes of Capitellar Osteochondritis Dissecans.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: The authors declared that they have no conflicts of interest in the authorship and publication of this contribution. 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. 20. Am J Sports Med. 2024 Dec;52(14):3543-3550. doi: 10.1177/03635465241296133. Epub 2024 Nov 25. A Simple Clinical Predictive Model for Arthroscopic Mobility of Osteochondritis Dissecans Lesions of the Knee. Milewski MD(1)(2), Miller PE(1)(2), Gossman EC(1)(2), Coene RP(1)(2), Tompkins MA(3)(2), Anderson CN(4)(2), Bauer K(5)(2), Busch MT(6)(2), Carey JL(7)(2), Carsen S(8)(2), Chambers HG(9)(2), Coene RP(1)(2), Edmonds EW(10)(2), Ellermann J(11)(2), Ellis HB Jr(12)(2), Erickson J(13)(2), Fabricant PD(14)(2), Ganley TJ(15)(2), Gossman EC(1)(2), Green DW(14)(2), Heyworth BE(16)(2), Hoi Po Hui J(17)(2), Kocher MS(16)(2), Krych AJ(18)(2), Latz K(19)(2), Lyon RM(20)(2), Mayer S(21)(2), Milewski MD(22)(2), Miller PE(1)(2), Nelson BJ(11)(2), Nepple JJ(23)(2), Nguyen JC(24)(2), Nissen CW(25)(2), Lee Pace J(5)(2), Paterno MV(26)(2), Pennock AT(27)(2), Perkins C(6)(2), Polousky JD(28)(2), Saluan P(29)(2), Shea KG(30)(2), Tompkins MA(31)(2), Wall EJ(32)(2), Weiss JM(33)(2), Willimon C(6)(2), Wilson P(12)(2), Wright RW(34)(2), Zbojniewicz A(35)(2), Myer GD(36)(2). Author information: (1)Division of Sports Medicine, Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts. (2)Investigation performed at the Division of Sports Medicine, Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts, USA. (3)Gillette Children's Specialty Healthcare, Minneapolis, Minnesota; University of Minnesota, Minneapolis, Minnesota; TRIA Orthopaedic Center, Minneapolis, Minnesota. (4)Tennessee Orthopaedic Alliance, Nashville, Tennessee. (5)Children's Health Andrews Institute, Plano, Texas. (6)Children's Healthcare of Atlanta, Atlanta, Georgia. (7)University of Pennsylvania, Philadelphia, Pennsylvania. (8)University of Ottawa, Ottawa, Canada. (9)San Diego Children's Hospital, San Diego, California. (10)Rady Children's Hospital San Diego, San Diego, California. (11)University of Minnesota, Minneapolis, Minnesota. (12)Texas Scottish Rite Hospital for Children, Dallas, Texas. (13)Children's Wisconsin, Milwaukee, Wisconsin. (14)Hospital for Special Surgery, New York, New York. (15)The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. (16)Boston Children's Hospital, Boston, Massachusetts. (17)National University of Singapore, Singapore. (18)Mayo Clinic, Rochester, Minnesota. (19)Children's Mercy Hospital, Kansas City, Missouri. (20)Medical College of Wisconsin, Milwaukee, Wisconsin. (21)University of Colorado, Englewood, Colorado. (22)Division of Sports Medicine, Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts, and Harvard Medical School, Boston, Massachusetts. (23)Washington University School of Medicine in St Louis, St Louis, Missouri. (24)Children's Hospital of Philadelphia, Philadelphia, Pennsylvania. (25)University of Connecticut, Farmington, Connecticut. (26)Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. (27)Rady Children's Hospital, San Diego, California. (28)Akron Children's Hospital, Akron, Ohio. (29)Cleveland Clinic, Cleveland, Ohio. (30)Stanford School of Medicine, Stanford, California. (31)Gillette Children's Specialty Healthcare, University of Minnesota, and TRIA Orthopaedic Center, Minneapolis, Minnesota. (32)Cincinnati Children's Hospital, Cincinnati, Ohio. (33)Shriners Children's Hawai'i, Honolulu, Hawai'i. (34)Vanderbilt University Medical Center, Nashville, Tennessee. (35)Grand Rapids, Michigan. (36)Emory Sports Performance and Research Center(SPARC), Flowery Branch, Georgia; Emory Sports Medicine Center, Atlanta, Georgia; Emory Sports Medicine Center, Atlanta, Georgia, USA; Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia. BACKGROUND: Osteochondritis dissecans (OCD) of the knee is a focal idiopathic alteration of subchondral bone and/or its precursor with risk for instability and disruption of adjacent cartilage. Treatment options focused on preventing premature osteoarthritis vary depending on multiple patient and lesion characteristics, including lesion mobility. PURPOSE: To differentiate lesion mobility before arthroscopy using a multivariable model that includes patient demographic characteristics and physical examination findings. STUDY DESIGN: Cohort study (Diagnosis); Level of evidence, 2. METHODS: Demographic, preoperative physical examination, and radiographic data were collected from a multicenter national prospective cohort of patients with OCD of the knee. Inclusion criteria included patients 54.4 kg (P = .12). In the 25% holdout validation sample (n = 102), a sensitivity of 83%, a specificity of 82%, and an AUC of 0.89 (95% CI, 0.82-0.95) were achieved with these predictive factors. CONCLUSION: Age, effusion, and loss of motion can predict knee OCD lesion mobility at the time of arthroscopy. Education about lesion mobility can help with surgical planning and patient and family counseling. DOI: 10.1177/03635465241296133