Increased contact pressure at the radiocapitellar joint with anterior and posterior osteochondral defects in the sagittal section of the humeral capitellum: a cadaveric study

In osteochondritis dissecans of the humeral capitellum, defect location and size were important in surgical planning. Recently, it was reported that posterior or large osteochondral defects of the humeral capitellum on pre-operative sagittal computed tomography affected outcomes of arthroscopic d&#xe9;bridement for osteochondritis dissecans in adolescent baseball players. Here, we investigated radiocapitellar joint contact pressure for anterior and posterior osteochondral defect positions in the sagittal section of the humeral capitellum. An anterior or posterior osteochondral defect of the humeral capitellum (10 mm in diameter) was created on each side in 7 matched pairs of fresh-frozen cadavers. Radiocapitellar joint contact pressure was measured with and without valgus stress at 0&#xb0;, 30&#xb0;, 60&#xb0;, and 90&#xb0; of elbow flexion and with and without varus stress at 0&#xb0; of elbow extension. In the posterior defect group, comparison of radiocapitellar joint contact pressure was significantly greater when the elbow joint was at 0&#xb0; extension and 90&#xb0; flexion than at other angles with valgus and varus stress (P < .05). Lower locations in posterior defects in the sagittal section showed significantly greater radiocapitellar joint contact pressure at 0&#xb0; extension and 90&#xb0; flexion of elbow joint with valgus stress (both P < .05). Radiocapitellar joint contact pressure with valgus and varus stress was significantly greater with a posterior osteochondral defect than with an anterior defect when the elbow joint was at 0&#xb0; extension and 90&#xb0; flexion. For posterior defects, the contact pressure increased at lower locations in defects in the sagittal section.