Challenge of the Week / Shoulder & Elbow / 02.07.20

A 16-year-old female patient who is a high school softball pitcher presents with failed treatment of an osteochondritis dissecans of the capitellum. Magnetic resonance imaging shows a contained lesion sized 6 x 6 mm with high signal and incongruency through the chondral cap. Treatment should include elbow arthroscopy with which of the following?
  • Fragment excision and marrow stimulation
  • The operative approach for small contained lesions includes excision and marrow stimulation and has good results.

  • Fragment excision and osteochondral autograft transfer
  • The operative approach for small contained lesions includes excision and marrow stimulation and has good results. Larger lesions are treated with osteochondral autograft transfers.

  • Bone marrow aspirate concentrate injection
  • The operative approach for small contained lesions includes excision and marrow stimulation and has good results.

  • Fragment excision and posterolateral ligament complex reconstruction
  • operative approach for small contained lesions includes excision and marrow stimulation and has good results. The ligaments are intact in these patients and do not require reconstruction.

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