Introduction Osteochondritis Dissecans of the elbow is a rare condition classically affecting teenage males playing throwing sports. The aim of this study was to evaluate the longer term outcome following arthroscopic debridement in patients with osteochondritis of the elbow that had failed conservative management.

Methods All clinically, radiologically and arthroscopically proven patients (since 1989) with Osteochondritis Dissecans (OCD) that had failed six months of non-operative management were recalled for clinical, performance indices and radiological review. A 91% follow-up rate was achieved (62% full clinical and radiological follow-up). The group consisted of 29 patients (20 male, nine female) with an average age of 22 years. Patients were mobilised post-operatively as symptoms allowed.

Results At an average of 77 months after the operation, the majority of patients had mild or no pain with activities of daily living but with some discomfort during heavy lifting/sports. Only four out of 27 had to give up their preferred sport because of persistent elbow problems. Thirty-eight percent had recurrence of locking or catching, though these symptoms were described as much better than prior to the operation and were not felt severe enough to consider any further intervention.

Conclusions We conclude that arthroscopic debridement and removal of loose bodies is a safe and reliable procedure for patients with persistent symptoms from OCD of the elbow.

Aims: This study aimed to assess the outcome of arthroscopic debridement and removal of loose bodies from the elbows of patients with OCD of the capitellum who had previously failed non-operative treatment. Methods: Patients who had been treated arthroscopically for symptomatic OCD of the capitellum after failing non-operative management for 6 months were invited for review. They were assessed clinically, by an independent examiner using a modern elbow outcome score, and radiologically. In addition details of sporting involvement and satisfaction of outcome were ascertained. Results: 29 patients/elbows (91% follow up rate) were assessed at a mean follow up period of 77 months. There were 20 males and 9 females with an average age at operation of 22 years. There were no operative complications. 26 patients had none or mild pain and were able to complete activities of daily living with minimal impairment. 27 patients had been regularly involved in sports (Olympic and professional to recreational levels) only 4 of whom had to give up the sport because of ongoing problems. 5 of 6 elite gymnasts and 10 of 11 rugby players were able to fully resume their sport. 11 patients (38%) had recurrence of locking episodes. There was an average 5û loss of ßexion and a 10û loss of extension while the grip strength remained normal. Radiographs demonstrated that most of the capitella had not remodelled. 28 (97%) patients had a good or excellent outcome. Conclusions: This study has demonstrated that arthroscopic treatment of recalcitrant OCD of the capitellum is a safe procedure resulting in satisþed patients most of whom can return their previous level of sports but there is a risk of recurrent locking symptom.

We report four patients with a mean age of 17 years (14 to 22) with external rotation injuries of the knee in slight flexion. Radiographs showed a small fragment in the area of the lateral femoral condyle. At operation, the fragment, consisting of the femoral insertion of the popliteus, was anatomically reduced and fixed. At a mean follow-up of 35 months all the knees had an excellent function score. An isolated lesion of the popliteus often presents as a tendon avulsion whereas major damage to the posterolateral corner of the knee involves combined ligamentous injuries. In patients with an acute haemarthrosis and lateral pain in a stable knee, the diagnosis of isolated avulsion of the popliteus tendon should be suspected. Arthroscopy with special attention to the lateral gutter is indicated. We advise anatomical reduction and fixation of the fragment to prevent possible long-term effects on other posterolateral structures.