Proxy for the surgery for elbow osteochondritis dissecans in adolescent baseball players

Capitellar osteochondritis dissecans (OCD) is a disorder frequently affecting adolescent athletes and can lead to chronic disability or surgery. While preventive measures have been advocated, there is no established method to monitor the prevalence of OCD. This study aimed to validate the use of surgical codes from the Japanese national database as proxies for OCD.

A retrospective epidemiological analysis was conducted using the Japanese national claims database from 2014 to 2022. Surgical procedures potentially linked to OCD, including drilling, bone débridement, synovectomy, and loose-body removal were analyzed by age, sex, and geographic distribution. Bibliometric data on OCD-related publications were extracted to assess their correlation with regional surgical incidence. Statistical analyses were performed to evaluate the validity of these surgical codes as proxies for OCD.

Loose-body removal was the most strongly associated with OCD, with 97% of procedures performed on males and 64% on patients under 20 years of age. Significant regional variation was observed, with Tokushima Prefecture showing the highest incidence of loose-body removal, mirroring its strong publication record on this topic. In contrast, drilling and bone débridement showed weaker demographic alignment with OCD and no significant correlation with publication activity. Synovectomy demonstrated moderate regional alignment but lacked demographic specificity for OCD.

This study highlights the utility of surgical codes from the national database in approximating OCD epidemiology, with loose-body removal serving as a reliable proxy. These findings establish a foundation for future studies to assess preventive strategies and guide resource allocation for OCD management in youth athletes.