Donor-site Morbidity After Osteochondral Autologous Transplantation for Osteochondritis Dissecans of the Capitellum: a Systematic Review and Meta-analysis

Overview

Journal Knee Surg Sports Traumatol Arthrosc

Publisher Wiley

Specialties Emergency Medicine
General Surgery
Orthopedics

Date 2017 Apr 10

PMID 28391550

Citations 27

Authors

Rens Bexkens

Paul T Ogink

Job N Doornberg

Gino M M J Kerkhoffs

Denise Eygendaal

Luke S Oh

Michel P J van den Bekerom

Affiliations

Soon will be listed here.

Abstract

Purpose: To determine the rate of donor-site morbidity after osteochondral autologous transplantation (OATS) for capitellar osteochondritis dissecans.

Methods: A literature search was performed in PubMed/MEDLINE, Embase, and Cochrane Library to identify studies up to November 6, 2016. Criteria for inclusion were OATS for capitellar osteochondritis dissecans, reported outcomes related to donor sites, ≥10 patients, ≥1 year follow-up, and written in English. Donor-site morbidity was defined as persistent symptoms (≥1 year) or cases that required subsequent intervention. Patient and harvest characteristics were described, as well as the rate of donor-site morbidity. A random effects model was used to calculate and compare weighted group proportions.

Results: Eleven studies including 190 patients were included. In eight studies, grafts were harvested from the femoral condyle, in three studies, from either the 5th or 6th costal-osteochondral junction. The average number of grafts was 2 (1-5); graft diameter ranged from 2.6 to 11 mm. In the knee-to-elbow group, donor-site morbidity was reported in 10 of 128 patients (7.8%), knee pain during activity (7.0%) and locking sensations (0.8%). In the rib-to-elbow group, one of 62 cases (1.6%) was complicated, a pneumothorax. The proportion in the knee-to-elbow group was 0.04 (95% CI 0.0-0.15), and the proportion in the rib-to-elbow group was 0.01 (95% CI 0.00-0.06). There were no significant differences between both harvest techniques (n.s.).

Conclusions: Donor-site morbidity after OATS for capitellar osteochondritis dissecans was reported in a considerable group of patients.

Level Of Evidence: Level IV, systematic review of level IV studies.

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