Outcomes and Return to Sport after Osteochondral Autograft Transplantation for Osteochondritis Dissecans of the Capitellum: A Systematic Review

Purpose Capitellar osteochondritis dissecans (OCD) lesions are common in athletes. Osteochondral autograft transfer is one possible treatment option, though outcomes including return to sport data are limited to small series. The purpose of this study was to systematically review return to sport (RTS) following osteochondral autograft transfer (OAT) for capitellar OCD lesions. Our secondary objectives were to evaluate patient reported outcomes (PROs), range of motion (ROM), and complications after OAT. Methods PubMed, Embase, and CINAHL were searched for peer-reviewed articles on “osteochondral autograft transfer” and related terms for capitellar OCD lesions. Articles were included if they reported an RTS rate and had a follow-up time point of at least 12 months. Data on RTS rates, PRO measures, complications, and ROM were extracted. Articles were assessed for methodological quality using the Methodological Index for Non-randomized Studies (MINORS) criteria. Results Six-hundred sixty-six articles were retrieved, and 24 articles (470 patients) met the inclusion criteria. In total 454/470 patients (97%) returned to sports following OAT for OCD. The RTS rate ranged from 79% to 100%. Return to previous level of performance ranged from 10% to 100%. Timmerman-Andrews postoperative scores (Range = 169 to 193) were most often reported, with 87% of patients showing scores within the excellent range. Disabilities of the Arm, Shoulder and Hand and Japanese Orthopedic Association scores were also excellent postoperatively for all studies reporting, with higher scores among centralized lesions vs. lateral. Conclusions Following OAT for capitellar OCD lesions, RTS rates are high; however, athletes should be counseled on the potential of a return to lower performance or need to change positions. Lateral lesion location may negatively impact outcomes. Patient reported outcome scores are typically excellent and postoperative range of motion consistently improves. This information helps counsel patients regarding expectations and outcomes of OAT for OCD of the capitellum.