0
Scientific Articles   |    
Cylindrical Costal Osteochondral Autograft for Reconstruction of Large Defects of the Capitellum Due to Osteochondritis DissecansSurgical Technique
Kozo Shimada, MD, PhD1; Hiroyuki Tanaka, MD, PhD1; Taiichi Matsumoto, MD2; Junichi Miyake, MD3; Haruhisa Higuchi, MD, PhD4; Kazushige Gamo, MD4; Takeshi Fuji, MD, PhD1
1 Department of Orthopaedic Surgery, Osaka Koseinenkin Hospital, 4-2-78 Fukushima, Fukushima-ku, Osaka 553-0003, Japan. E-mail address for K. Shimada: k-shimada1960@nifty.com
2 Department of Orthopaedic Surgery, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan
3 Department of Orthopaedics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita Osaka 565-0871, Japan
4 Department of Orthopaedic Surgery, Hoshigaoka Koseinenkin Hospital, 4-8-1 Hoshigaoka, Hirakata, Osaka 573-8511, Japan
View Disclosures and Other Information
  • Disclosure statement for author(s): PDF

Based on an original article: J Bone Joint Surg Am. 2012 Jun 6;94(11):992-1002.



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
JBJS Essential Surgical Techniques, 2012 Jun 27;2(2):e12 1-11. doi: 10.2106/JBJS.ST.K.00037
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case

Extract

Overview
Introduction

We describe our technique of cylindrical costal osteochondral autograft for elbows with advanced osteochondritis dissecans.

Step 1: Prepare and Position the Patient

Mark the ipsilateral (fifth or sixth) rib.

Step 2: Excise/Debride the Lesion and Create a Cylindrical Hole

Debride necrotic fibrous tissue completely.

Step 3: Elevate the Costal Osteochondral Junction

Elevate the graft carefully from the periosteum and perichondrium to avoid damage to the pleura.

Step 4: Prepare the Osteochondral Autograft

Shape the harvested osteochondral junction like a cone about 18 mm in height, including a 5-mm-high cartilage cap.

Step 5: Place the Graft into the Defect and Close

After packing the grafts, shape and contour the cartilage surface to fit the radial head using a scalpel.

Step 6: Postoperative Treatment

Most patients are able to perform normal daily activities in a few days or a week, but they are not allowed to play sports for three months.

Results

Between 2006 and 2010, we performed this operation in forty-three patients with severe osteochondritis dissecans of the humeral capitellum, and twenty-six cases were followed for more than twenty-four months12.

What to Watch For

Indications

Contraindications

Pitfalls & Challenges

Figures in this Article

    First Page Preview

    View Large
    />
    First page PDF preview
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS Essential Surgical Techniques?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

     
    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org

    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe





    Related Content
    The Journal of Bone & Joint Surgery
    Essential Surgical Techniques
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    Guidelines
    Results provided by:
    PubMed
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    04/02/2014
    WY - Memorial Hospital of Sweetwater County
    03/19/2014
    NY - KINGS COUNTY HOSPITAL CENTER
    12/04/2013
    NY - Icahn School of Medicine at Mount Sinai
    02/05/2014
    OR - The Center - Orthopedic and Neurosurgical Care and Research