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Arthroscopic Microfracture for Osteochondritis Dissecans Lesions of the Capitellum

February 10, 2018

Contributors: David W Altchek, MD; Christopher L. Camp, MD; Ryan Degen, FRCSC, MD, MSc; Joshua Dines, MD; Alec Sinatro, BA; Venkat Boddapati, BA; Venkat Boddapati, BA

Keywords: Bony Procedure

Capitellar osteochondritis dissecans (OCD) is one of the most common causes of elbow pain and dysfunction in adolescent athletes. Capitellar OCD typically occurs in gymnasts and overhead throwers and varies in severity. Stable lesions typically can be managed nonsurgically; however, patients with instability, fragmentation, or loose bodies generally require surgical treatment. Although a number surgical options can be used to manage capitellar OCD lesions, microfracture is one of the most commonly performed and well-studied procedures. Patients who are candidates for microfracture generally experience favorable outcomes, with a high rate of return to athletic activity after postoperative rehabilitation. This video presents our preferred arthroscopic technique for microfracture of capitellar OCD lesions. This technique is most suitable in patients with unstable or fragmented OCD lesions that are less than 1 cm in diameter and do not violate the lateralmost articular margin of the capitellum. In addition, we describe required equipment, postoperative rehabilitation, and key takeaway points.