Poster 201. Tumbling Athletes Sustain Highest Rate of Bilateral Elbow Osteochondritis Dissecans Lesions and May Benefit From Screening

Le résumé fourni par la source

Objective: Osteochondritis dissecans (OCD) lesions frequently present at the capitellum of the elbow, particularly among athletes who participate in overhead sports or impact load through their upper extremity. Bilateral elbow OCD lesions are less common rare and can significantly impact sport participation and elbow function. Previous studies have shown that unique capitellar OCD characteristics are associated with specific sport participation such as gymnasts having more posterior lesions with lesser lesion containment. However, little is known about the presenting characteristics of patients with bilateral elbow OCD lesions. We hypothesized that tumbling athletes including gymnasts, cheerleaders, dancers would have an increased propensity for bilateral OCD lesions. Methods: A retrospective review was performed of a consecutive series of pediatric and adolescent patients with elbow OCD lesions who presented to a single tertiary care pediatric hospital between 2009-2025. Patients were identified using CPT and ICD codes. Data regarding patient demographics, sports participation, lesion characteristics on radiographs and magnetic resonance imaging, and timeline of presentation were collected for patients with bilateral elbow OCD lesions. Standard statistical analyses were performed to compare unilateral and bilateral lesions (p<0.05). Results: A total of 279 consecutive patients with a diagnosis of elbow OCD with a mean age of 13.4 (8.0-19.1) years were included, of which 10.3% (n=29) were determined to have bilateral lesions. Patients with bilateral lesions were younger compared to unilateral lesions (12.9 vs 13.4, p<0.001). Compared to unilateral lesions, bilateral lesions were observed at higher rates among females (79.43% vs 38.2%, p<0.001) and in tumbling athletes (72.4% vs 32.8%, p<0.001). Bilateral lesions were noted at a mean sagittal inclination angle of 38 (±14.1) degrees, indicating that these lesions tended to occur on the posterior aspect of the capitellum. Of the 29 bilateral patients, only 7 (24.1%) had bilateral lesions concomitantly identified at initial presentation, while 22 (75.9%) had their bilateral lesions found sequentially. The majority (26/29, 90.0%) of the secondary lesions were identified after becoming symptomatic, whereas 3 (10.3%) secondary lesions were noted incidentally. Conclusions: In our series, bilateral elbow OCD occurred at an incidence of 10.3%; however, the incidence was over double in tumbling athletes. Bilateral lesions were more common in young females. Due to the high level of prevalence in tumbling athletes, consideration should be given for contralateral elbow screening at initial presentation in these patients, and screening should be promptly performed at the initiation of contralateral symptoms.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.