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New Treatment for Baseball Pitchers with Osteochondritis Dissecans

Repetitive stress at the elbow from pitching can cause a problem called osteochondritis dissecans in teenage baseball players. In this condition the cartilage protecting the elbow joint separates or pulls away from the bone. It can take the first thin layer of bone called subchondral bone with it.

In this study, doctors review the method and results of a new treatment called mosaicplasty for this problem. Small plugs of bone graft were taken from the bottom of players’ femurs (thigh bone). These were transplanted to the elbow and inserted into holes drilled where the defect or damage had occurred.

Bone used from the patient is called a autologous. The entire procedure is called an autologous osteochondral grafting or mosaicplasty. The results of the mosaicplasty are reported for eight teenagers baseball pitchers.

Follow-up two years after the mosaicplasty showed seven patients with a good to excellent results. All seven were free of pain and had increased elbow motion. Based on symptoms, motion, and function, all players could have returned to baseball. Six did go back to playing baseball (including three who were pitchers) but two others went on to play rugby and football instead.

The authors say that mosaicplasty is a good treatment for severe articular tears in teenaged baseball players. Even displaced and detached fragments can be successfully treated this way.

Athletes were able to return to full sports participation. This is not usually possible with other methods of treatment such as removing or smoothing the torn cartilage. Mosaicplasty has the added benefit of protecting against arthritis later.

References: Norimasa Iwasaki, MD, PhD, et al. Autologous Osteochondral Mosaicplasty for Capitellar Osetochondritis Dissecans in Teenaged Patients. In The American Journal of Sports Medicine. August 2006. Vol. 34. No. 8. Pp. 1233-1239.

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