Thirty-Six Months of Experience and 30° of Hip Internal Rotation as Critical Thresholds for Capitellar Osteochondritis Dissecans in Youth Baseball Players.

Abstract

Capitellar osteochondritis dissecans (OCD) is a serious throwing injury that can lead to long-term elbow dysfunction. While a longer duration of competitive play is a suspected risk factor, no specific cutoff value has been established to identify players at high risk. To identify independent risk factors for capitellar OCD and determine the optimal cutoff value for the duration of competitive play in youth baseball players. This cross-sectional study analyzed 853 youth baseball players (aged 9-12 years) who participated in medical check-ups. OCD was diagnosed using ultrasonography and confirmed by radiography. Eight candidate variables (weight, Rohrer index, baseball experience, history of pain, and internal rotation [IR] of the bilateral shoulders and hips) were analyzed. Independent risk factors were identified using multivariable logistic regression, with variable selection performed using a penalized regression approach and model validation based on the corrected Akaike information criterion. Optimal cutoff values were determined using receiver operating characteristic (ROC) curve analysis. The prevalence of OCD was 2.81% (24/853). Multivariable analysis identified three independent risk factors: longer baseball experience (p = 0.004), a history of shoulder or elbow pain (p = 0.035), and decreased internal rotation of the nondominant hip (p = 0.002). ROC curve analysis yielded an optimal cutoff value of 36 months for baseball experience (AUC = 0.704; sensitivity = 0.875; specificity = 0.508). For the nondominant hip, an internal rotation cutoff value of 30° was identified (AUC = 0.715; sensitivity = 0.625; specificity = 0.749). Baseball experience of 36 months or longer and nondominant hip internal rotation of less than 30° are significantly associated with OCD. These objective cutpoints may enhance the efficiency of medical screenings by identifying higher-risk players who need further evaluation. Given the cross-sectional design of this study, additional prospective research is needed to determine whether modifying these risk factors can reduce OCD incidence. Level III; Cross-Sectional Case-Control Design; Prognosis Study.