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Arthroscopic treatment of osteochondral lesions of the capitellum
Arthroscopy: The Journal of Arthroscopic and Related Surgery 10(3):328-357 Published by Raven Press, Ltd. © 1994 Arthroscopy Association of North America
Abstracts These are the abstracts of the papers presented at the Annual Meeting of the Arthroscopy Association of North America, which was held in Orlando, Florida, from April 28-May 1, 1994.
treated with arthroscopic debridement of osteochondral lesions of the elbow at 2V2 years. Complete return to preinjury level of activities was obtained in all patients, and significant improvement in subjective symptoms was obtained in most patients.
Arthroscopic Treatment of Osteochondral Lesions of the Capitellum. Kevin J. Kessler, Philip Lozman, and John W. Uribe. Coral Gables, Florida, U.S.A. Controversy exists in the literature as to the prognosis and treatment of osteochondral lesions of the capitellum. The extensive shear and compressive forces experienced by the capitellum led to the development of an osteochondral fragment of the articular cartilage. The purpose of this study was to evaluate the long-term results of osteochondral lesions of the capitellum that were treated arthroscopically. Eleven cases of osteochondral lesions of the capitellum were reviewed in 10 high-performance male athletes. Their ages ranged from I1 to 16 years (mean 14). The study sample was composed of nine dominant and two nondominant elbows. All patients were treated arthroscopically with debridement of the osteochondral defect, curettage of loose articular margins, and removal of loose fragments. The average length of follow-up was 2~/2years. Preoperatively, the patients frequently complained of loss of motion, locking, clicking, swelling, and pain. All patients were interviewed and examined by the author (K.J.K.). Using the Morrey objective elbow scoring scale, there were seven excellent, four good, and no fair or poor results. Subjectively, eight patients noted they were much better. None were the same or worse. Fifty percent of the patients stated that it took 3-6 months to regain full range of motion, and 100% of the patients returned to sports at their previous level of play at <1 year. There were no complaints of neurosensory symptoms or complications. Most patients showed a decrease in range of motion averaging 5° loss of extension. Postoperatively, radiographs showed filling of the defect. Arthroscopic surgery of the elbow has become an effective and acceptable tool in the diagnosis and treatment of injuries of the elbow. This study demonstrates excellent results in 75% of the patients
Arthroscopic Bankart Repair with the Suretac Device: Clinical and Experimental Observations. Jon J. P. Warner, Mark D. Miller, and Paul H. Marks. Center for Sports Medicine, Pittsburgh, Pennsylvania, U.S.A. We describe the appearance of arthroscopic Bankart repair "second-look" surgery and define the technical limitations of this procedure. Conclusions: Suretac repair of Bankart lesions may be associated with incomplete healing. This appears to be related to tissue preparation and placement of the tac devices. Significance: Partial healing of the Bankart lesion with Suretac repair may be a risk factor for recurrent instability and may be improved by careful preparation of the soft tissues and accurate placement of the tues. Methods: Sixty patients underwent arthroscopic Bankart repair using the Suretac device over a 2-year period. Seven patients subsequently underwent a second-look arthroscopy at an average of 7 months (range 4-12) after the initial surgery. The indication for the second surgery was recurrent instability in three patients, refractory loss of motion in one, biceps tendinitis in one, and impingement in two. All patients were men, with an average age of 35 years (range 28-50). Six fight and one left shoulders were involved. Initial diagnosis before Suretac repair was subluxation in six shoulders and dislocation in one. Two patients also had a SLAP lesion repaired at the time of initial surgery. In all patients the Bankart lesion was repaired with two Suretacs. Findings at time of second-look arthroscopy were complete healing of the Bankart lesion in one, corn328
Abstracts These are the abstracts of the papers presented at the Annual Meeting of the Arthroscopy Association of North America, which was held in Orlando, Florida, from April 28-May 1, 1994.
treated with arthroscopic debridement of osteochondral lesions of the elbow at 2V2 years. Complete return to preinjury level of activities was obtained in all patients, and significant improvement in subjective symptoms was obtained in most patients.
Arthroscopic Treatment of Osteochondral Lesions of the Capitellum. Kevin J. Kessler, Philip Lozman, and John W. Uribe. Coral Gables, Florida, U.S.A. Controversy exists in the literature as to the prognosis and treatment of osteochondral lesions of the capitellum. The extensive shear and compressive forces experienced by the capitellum led to the development of an osteochondral fragment of the articular cartilage. The purpose of this study was to evaluate the long-term results of osteochondral lesions of the capitellum that were treated arthroscopically. Eleven cases of osteochondral lesions of the capitellum were reviewed in 10 high-performance male athletes. Their ages ranged from I1 to 16 years (mean 14). The study sample was composed of nine dominant and two nondominant elbows. All patients were treated arthroscopically with debridement of the osteochondral defect, curettage of loose articular margins, and removal of loose fragments. The average length of follow-up was 2~/2years. Preoperatively, the patients frequently complained of loss of motion, locking, clicking, swelling, and pain. All patients were interviewed and examined by the author (K.J.K.). Using the Morrey objective elbow scoring scale, there were seven excellent, four good, and no fair or poor results. Subjectively, eight patients noted they were much better. None were the same or worse. Fifty percent of the patients stated that it took 3-6 months to regain full range of motion, and 100% of the patients returned to sports at their previous level of play at <1 year. There were no complaints of neurosensory symptoms or complications. Most patients showed a decrease in range of motion averaging 5° loss of extension. Postoperatively, radiographs showed filling of the defect. Arthroscopic surgery of the elbow has become an effective and acceptable tool in the diagnosis and treatment of injuries of the elbow. This study demonstrates excellent results in 75% of the patients
Arthroscopic Bankart Repair with the Suretac Device: Clinical and Experimental Observations. Jon J. P. Warner, Mark D. Miller, and Paul H. Marks. Center for Sports Medicine, Pittsburgh, Pennsylvania, U.S.A. We describe the appearance of arthroscopic Bankart repair "second-look" surgery and define the technical limitations of this procedure. Conclusions: Suretac repair of Bankart lesions may be associated with incomplete healing. This appears to be related to tissue preparation and placement of the tac devices. Significance: Partial healing of the Bankart lesion with Suretac repair may be a risk factor for recurrent instability and may be improved by careful preparation of the soft tissues and accurate placement of the tues. Methods: Sixty patients underwent arthroscopic Bankart repair using the Suretac device over a 2-year period. Seven patients subsequently underwent a second-look arthroscopy at an average of 7 months (range 4-12) after the initial surgery. The indication for the second surgery was recurrent instability in three patients, refractory loss of motion in one, biceps tendinitis in one, and impingement in two. All patients were men, with an average age of 35 years (range 28-50). Six fight and one left shoulders were involved. Initial diagnosis before Suretac repair was subluxation in six shoulders and dislocation in one. Two patients also had a SLAP lesion repaired at the time of initial surgery. In all patients the Bankart lesion was repaired with two Suretacs. Findings at time of second-look arthroscopy were complete healing of the Bankart lesion in one, corn328