BACKGROUND Autologous osteochondral grafting (OG) is an option in the treatment of capitellar osteochondritis dissecans (COCD). However, radiographic healing after this procedure has not been well documented. PURPOSE To develop a magnetic resonance imaging (MRI)-based scoring system specific for evaluating healing after single-plug OG in COCD and to evaluate correlation between radiographic healing and early clinical outcomes. STUDY DESIGN Cohort study (diagnosis); Level of evidence, 3. METHODS Between 2014 and 2017, 183 elbows with COCD were enrolled in a prospective registry. A total of 61 elbows in 59 patients underwent single-plug OG. Of these, 52 elbows in 50 patients had pre- and postoperative MRI scans. Postoperative MRI and clinical outcome data from this group were used to develop the novel BOGIE score (Boston Osteochondral Graft Incorporation in the Elbow), with a possible range of 4 to 12. RESULTS Median age at surgery was 14.2 years (interquartile range, 13.1-15.0 years). Median clinical follow-up after OG was 12.4 months (interquartile range, 9.5-16.9 months; range, 6-53 months). Compared with before surgery, elbow function at 6 months after surgery and at latest follow-up was significantly improved as measured by the Timmerman and Andrews score (TAS; median: 145 before surgery, 185 at 6 months after surgery, 190 at latest follow-up; P < .001, before vs after surgery), as well as the short version of Disabilities of the Arm, Shoulder and Hand score; median: 21 before surgery, 7 at 6 months after surgery, and 0 at latest follow-up; P < .001 before surgery vs after surgery). Median BOGIE score at 6 months after surgery was 10 (range, 4-12). BOGIE score intraobserver reliability was 0.90 (95% CI, 0.82-0.94) for reader 1 and 0.91 (95% CI, 0.86-0.95) for reader 2. Interobserver reliability between the readers was 0.86 (95% CI, 0.78-0.92). Correlation was observed between the 6-month BOGIE score and the concurrent postoperative objective TAS (P < .001) as well as total TAS (P = .01) but not the subjective TAS (P = .08). Patients who underwent subsequent secondary surgery for persistent symptoms had a significantly lower postoperative BOGIE score at 6 months than those who did not (median, 7.8 vs 10.3; P = .016). CONCLUSION Quantitative evaluation for radiologic healing after single-plug OG in COCD is possible. The MRI-based BOGIE score appears to correlate with early clinical function and may be useful as an adjunct tool in decision making on activity progression. The use of a standardized MRI score may improve comparability of outcomes after OG in the literature.

中文翻译：

---

自体软骨软骨剥离的自体骨软骨移植后的早期放射学愈合和功能结果：基于磁共振成像的新评分系统的介绍。

背景技术自体骨软骨移植术（OG）是剥离小头骨软骨炎（COCD）的一种选择。但是，此过程后的放射线愈合尚未得到充分记录。目的开发基于磁共振成像（MRI）的评分系统，专门用于评估COCD单插OG后的愈合情况，并评估放射线愈合与早期临床结果之间的相关性。研究设计队列研究（诊断）；证据等级，3。方法在2014年至2017年之间，前瞻性登记处登记了183例患有COCD的肘。59例患者中总共61例肘部接受了单插头OG。其中，50例患者中的52个肘部在术前和术后进行了MRI扫描。该组患者的术后MRI和临床结局数据用于建立新的BOGIE评分（肘部合并波士顿骨软骨移植术），可能的范围为4至12。结果手术中位年龄为14.2岁（四分位间距为13.1）。 15.0年）。OG后的中位临床随访时间为12.4个月（四分位间距为9.5-16.9个月；范围为6-53个月）。与手术前相比，根据Timmerman和Andrews评分（TAS；中位数：手术前145，手术后6个月185，手术后190），手术后6个月和最新随访的肘关节功能明显改善。向上； P <.001，手术前后对比），以及臂，肩和手残疾评分的简写；中位：术前21，术后6个月7，最近一次随访0；P <.001手术前vs手术后）。术后6个月的BOGIE评分中位数为10（范围4-12）。BOGIE评分阅读器1的观察者内部可靠性为0.90（95％CI，0.82-0.94），阅读器2为0.91（95％CI，0.86-0.95），阅读器之间的观察者之间可靠性为0.86（95％CI，0.78-0.92）。观察到6个月BOGIE评分与同时进行的术后客观TAS（P <.001）和总TAS（P = .01）之间的相关性，但与主观TAS（P = .08）之间没有相关性。因持续症状而接受后续第二次手术的患者在术后6个月的BOGIE评分显着低于未接受术后患者的BOGIE评分（中位数7.8对10.3； P = 0.016）。结论可以对COCD中单插头OG后的放射学愈合进行定量评估。基于MRI的BOGIE评分似乎与早期临床功能相关，并且可以作为辅助工具来进行活动进展的决策。在文献中，使用标准的MRI评分可以改善OG后结局的可比性。