{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:43:25Z","timestamp":1787755405799,"version":"build-2784847793"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JBJS Essential Surgical Techniques"],"abstract":"\n Background:<\/jats:title>\n \n Capitellar osteochondritis dissecans (OCD) is a focal injury of the articular cartilage involving separation of a segment of cartilage from the subchondral bone that is infrequently encountered in the dominant-side elbow of adolescent throwing athletes\n 1,2<\/jats:sup>\n . The literature suggests that patients may achieve better short and mid-term results when treated with certain types of surgical procedures\n 3,4<\/jats:sup>\n . Selection of the appropriate surgical method should be based on the International Cartilage Repair Society (ICRS) OCD classification system\n 5<\/jats:sup>\n . For lesions involving \u226450% of the surface area of the capitellum, debridement with microfracture and\/or loose body removal have shown excellent results. For lesions involving >50% of the surface area of the capitellum and classified as ICRS OCD III or IV, autologous osteochondral grafting may be the most suitable treatment\n 6\u20138<\/jats:sup>\n . Bone peg grafting (BPG) has been shown to be an effective treatment option for early-stage capitellar OCD that can preserve the local hyaline cartilage\n 9,10<\/jats:sup>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Description:<\/jats:title>\n \n Using direct vision and with arthroscopy, the continuity of the capitellar surface and the stability of the capitellar lesion were evaluated according to the ICRS OCD classification\n 5<\/jats:sup>\n . BPG was indicated for adolescents with ICRS OCD I or II. The elbow was opened between the extensor carpi ulnaris and the anconeus muscle (Kocher interval). Another skin incision of 3 cm in length was made at the posterior aspect of the metaphysis of the ipsilateral olecranon. Three, 4, or 5 bone pegs of approximately 20 mm in length were harvested from the posterior ulnar cortex. A Kirschner wire of 3 mm in diameter was used for drilling holes in the lesion, and then the bone pegs were inserted with tweezers to a depth of 10 mm. Next, a flat-surfaced rod was placed on the head of each bone peg to press it to a depth slightly lower than the articular cartilage surface. Postoperatively, the elbow was immobilized for 3 weeks. Throwing was allowed at 6 months, and a return to competitive baseball at preinjury levels was permitted at 8 months after BPG.\n <\/jats:p>\n <\/jats:sec>\n \n Alternatives:<\/jats:title>\n \n \n \n Arthroscopic debridement of the lesion.<\/jats:p>\n <\/jats:list-item>\n \n Arthroscopic bone marrow stimulation or microfracture.<\/jats:p>\n <\/jats:list-item>\n \n Fragment fixation using metal implants or biodegradable materials.<\/jats:p>\n <\/jats:list-item>\n \n Use of autologous osteochondral graft from the distal aspect of the femur or from a rib.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>\n \n Rationale:<\/jats:title>\n \n Our follow-up study after BPG revealed that 10 of 11 patients with ICRS OCD I or II capitellar OCD could return to their preinjury baseball ability and that 8 of the 11 lesions completely healed as seen radiographically\n 11<\/jats:sup>\n . Radiographic and magnetic resonance imaging (MRI) findings showed that BPG could secure the lesion to the osseous floor as a physiological scaffold. Fragment fixation with metal implants or biodegradable materials carries a risk of damaging cartilage surfaces, and autologous osteochondral grafting is too invasive for this early-stage lesion. BPG is indicated for ICRS OCD I or II lesions, especially with central positioning and\/or occupying <75% of the size of the capitellum in the coronal plane\n 11<\/jats:sup>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.2106\/jbjs.st.17.00058","type":"journal-article","created":{"date-parts":[[2018,3,14]],"date-time":"2018-03-14T13:55:40Z","timestamp":1521035740000},"page":"e8","source":"Crossref","is-referenced-by-count":7,"title":["Bone Peg Grafting for Capitellar Osteochondritis Dissecans in Adolescent Baseball Players"],"prefix":"10.2106","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4986-7735","authenticated-orcid":false,"given":"Hiroyuki","family":"Oshiba","sequence":"first","affiliation":[{"name":"Marunouchi Hospital, Matsumoto, Japan"},{"name":"Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiro","family":"Itsubo","sequence":"additional","affiliation":[{"name":"Sports Medicine Center, Aizawa Hospital, Matsumoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatoshi","family":"Komatsu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigeharu","family":"Uchiyama","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shinshu University School of Medicine, Matsumoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,3,28]]},"reference":[{"issue":"2","key":"bib1-20230812","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1007\/s00167-005-0623-z","article-title":"Arthroscopic treatment of osteochondritis dissecans of the capitellum","volume":"14","author":"Brownlow","year":"2006","journal-title":"Knee Surg Sports Traumatol Arthrosc."},{"key":"bib2-20230812","first-page":"125","article-title":"Bone peg fixation in the treatment of osteochondritis dissecans of the knee joint","volume":"143","author":"Gillespie","year":"1979","journal-title":"Clin Orthop Relat Res."},{"issue":"6","key":"bib3-20230812","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.2106\/00004623-200706000-00007","article-title":"Classification, treatment, and outcome of osteochondritis dissecans of the humeral capitellum","volume":"89","author":"Takahara","year":"2007","journal-title":"J Bone Joint Surg Am."},{"issue":"3","key":"bib4-20230812","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/S0278-5919(05)70270-2","article-title":"Osteochondritis dissecans of the humeral capitellum. 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