Extra-articular core tunneling and local autogenous bone grafting for osteochondritis dissecans lesion of the capitellum with intact articular cartilage and subchondral bone deficiency

Osteochondritis dissecans (OCD) is characterized by subchondral bone injury, loss of support for overlying articular cartilage, and failure of the articular surface. OCD generally presents in patients older than 10 years old, most commonly in males between 12 and 17 years old.10 One etiologic theory is that repetitive microtrauma compromises the subchondral bone’s vascular supply, resulting in focal avascular necrosis and loss of mechanical support for the overlying cartilage.2 Another theory is that repetitive loading results in a focal stress injury to the subchondral bone, which progresses to subsequent fracture, bone resorption, and loss of mechanical support for the chondral or osteochondral joint surface.