Abstract
PURPOSE: The minced cartilage technique is a single-stage cartilage repair option established for focal cartilage defects in larger joints, but evidence for its use in the elbow remains limited. The purpose of this study was to evaluate the clinical, sports-related and imaging outcomes of the minced cartilage technique in patients with unstable elbow osteochondritis dissecans (OCD). METHODS: Patients treated with minced cartilage for elbow OCD (DiPaola Grade III-IV) were included. Clinical outcomes were assessed using the Mayo Elbow Performance Score (MEPS), Quick Disabilities of the Arm, Shoulder and Hand score (qDASH), Subjective Elbow Score (SES), range of motion (ROM), pain intensity measured by the Numeric Rating Scale and return to sports. Postoperative magnetic resonance imaging (MRI) was evaluated using the Magnetic Resonance Observation of Cartilage Repair Tissue 2.0 (MOCART 2.0) score. RESULTS: Twelve patients with a mean age of 19.1 ± 8.1 years were included at a mean follow-up of 2.0 ± 0.9 years. Functional outcomes were excellent, with a mean MEPS of 97.1 ± 2.6, qDASH of 6.0 ± 3.7 and SES of 95.2 ± 5.6. All patients returned to sports after a mean of 5.3 months and to their pre-injury performance level after 6.7 months. ROM was preserved, with significant improvement in extension deficit. MRI demonstrated progressive cartilage repair over time, with no correlation between imaging and clinical outcomes. First MRI at a mean of 4.5 months showed a MOCART score of 68.6 ± 2.9, while the second MRI at a mean of 11.6 months demonstrated a significant increase to 74.0 ± 1.0 (p = 0.008). CONCLUSION: The minced cartilage technique for unstable elbow osteochondrosis dissecans resulted in excellent functional outcomes, rapid return to sports, preserved ROM and satisfactory cartilage repair on MRI imaging. These findings support its feasibility in young, athletic patients, although larger prospective studies are required. LEVEL OF EVIDENCE: Level IV.