JSES - 2026-03-17 - Journal Article
Increased contact pressure at the radiocapitellar joint with anterior and posterior osteochondral defects in the sagittal section of the humeral capitellum: a cadaveric study.
Iwase J, Matsuura T, Iwame T, Yokoyama K, Takamatsu N, Tomita K, Sairyo K
Topics
Key Takeaway
Posterior osteochondral defects of the humeral capitellum generate significantly greater radiocapitellar contact pressure than anterior defects at 0° extension and 90° flexion under both valgus and varus stress, with lower sagittal defect location further amplifying this pressure.
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Summary
This cadaveric study investigated whether anterior versus posterior 10-mm osteochondral defect position on the humeral capitellum affects radiocapitellar contact pressure across elbow flexion angles and under valgus/varus stress. Contact pressure was measured at 0°, 30°, 60°, and 90° flexion with and without applied stress loads. Posterior defects produced significantly greater contact pressure at 0° extension and 90° flexion under both valgus and varus stress, and more inferiorly located posterior defects amplified this effect further.
Key Limitation
The cadaveric model cannot replicate the dynamic, repetitive valgus loading of the adolescent throwing elbow, and the absence of active muscle forces means absolute contact pressure values may not translate directly to in vivo conditions.
Original Abstract
BACKGROUND
In osteochondritis dissecans (OCD) 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 preoperative sagittal computed tomography affected outcomes of arthroscopic debridement for OCD 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.
METHODS
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°, 30°, 60°, and 90° of elbow flexion and with and without varus stress at 0° of elbow extension.
RESULTS
In the posterior defect group, comparison of radiocapitellar joint contact pressure was significantly greater when the elbow joint was at 0° extension and 90° flexion than at other angles with valgus and varus stress (P < 0.05). Lower locations in posterior defects in the sagittal section showed significantly greater radiocapitellar joint contact pressure at 0° extension and 90° flexion of elbow joint with valgus stress. (both P < 0.05).
CONCLUSION
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° extension and 90° flexion. For posterior defects, the contact pressure increased at lower locations in defects in the sagittal section.