Extracellular Matrix With Bone Marrow Aspirate Concentrate for Osteochondritis Dissecans of the Capitellum in Adolescents.

Abstract

Capitellar osteochondritis dissecans is most frequently encountered in overhead and tumbling adolescent athletes. Traditional management with abrasion chondroplasty or microfracture results in fibrocartilage formation and variable return to sport rates, whereas osteochondral autograft transfer system or osteochondral allograft transplantation may incur unnecessary morbidity for small, shallow lesions. This article therefore describes the application of a biologic scaffold composed of extracellular matrix combined with bone marrow aspirate concentrate to unstable, shallow (<6-7 mm), but contained capitellar osteochondritis dissecans lesions through an anconeus-splitting arthrotomy. This technique provides excellent exposure of the capitellum and offers the potential for biologically favorable hyaline-like cartilage regeneration. With promising early clinical results, this approach is more easily implemented even for those without extensive elbow arthroscopy experience and represents a favorable middle-ground between microfracture and osteochondral autograft transfer system/ osteochondral allograft for adolescent athletes with capitellar osteochondritis dissecans lesions.