Are Elbow Osteochondritis Dissecans Lesions Different for Gymnasts and Baseball Players?

Abstract

Objective: Gymnasts and baseball players have different mechanisms of loading their elbows, and there is little data comparing osteochondritis dissecans (OCD) lesions between these 2 sports. Our objective is to compare the clinical and imaging characteristics of elbow OCD lesions between weight-bearing and throwing athletes.

Design: Review from 2015 to 2022.

Setting: Sports medicine clinics at a large academic center.

Patients: Thirty-four patients were included.

Independent variables: Patients were divided into 2 groups: gymnastics and baseball.

Main outcome measures: Location of elbow OCD lesion on the capitellum, stability of lesion, lesion size, and the presence of a radial head deformity.

Results: Twenty-two (65%) baseball players and 12 (35%) gymnasts were included with 97% (33/34) of athletes presenting with a capitellar lesion. Seventy-six percent of athletes had a radial head deformity with no difference in frequency between groups ( P = 0.61). There was also no difference in frequency of lesion instability ( P = 0.56) or lesion size. Baseball players had a higher frequency of lesions located anteriorly on the capitellum compared with gymnasts (28% vs 0%, P = 0.02), and gymnasts had a higher frequency of lesions located centrally (24% vs 58%, P = 0.02). Gymnasts had significantly different presenting symptoms ( P = 0.03) with a higher frequency of isolated pain.

Conclusions: There are no significant differences in the size, stability, or location of OCD lesions in weight-bearing and throwing athletes. The presence of an associated radial head deformity was seen on most radiographs without any difference between sport. Lesion location and symptoms at presentation are significantly different between gymnastics and baseball.

Level of evidence: III.