Treatment of Capitellar Osteochondritis Dissecans

Osteochondritis dissecans (OCD) of the capitellum causes pain, motion deficits, and activity limitations. Evaluation requires a thorough history, physical examination, radiographs, and magnetic resonance imaging. Surgery is indicated for patients with stable lesions who fail nonoperative treatment or who have unstable lesions and particularly when mechanical symptoms are present. Treatment is based on the size and stability of the lesion. Surgical treatment options include drilling for stable intact lesions and chondroplasty with drilling for unstable lesions. Arthroscopic mosaicplasty is an option for large lesions that allow the radial head to engage within the capitellar lesion.