Arthroscopic autogenous osteochondral transplantation for treating knee cartilage defects: a 2- to 5-year follow-up study.
OBJECTIVE
The purpose of this retrospective analysis was to evaluate the medium-term results of arthroscopic treatment of chondral and osteochondral lesions of the knee with autogenous osteochondral transplantation (AOT).


METHODS
Case series.


METHODS
Thirty-three skeletally mature patients with symptomatic, full-thickness cartilage lesions of the femoral condyles, between 1 and 2.5 cm in diameter, were treated with arthroscopic AOT. Grafts were harvested from the superior and lateral intercondylar notch and press-fit into holes drilled into the defect. All patients were evaluated both preoperatively and postoperatively with the Lysholm knee score, International Knee Documentation Committee (IKDC) Standard Evaluation Form, and knee joint radiographs.


RESULTS
Thirty patients of a mean age of 44.6 years were followed-up for a mean time of 45.1 months. Symptom duration ranged from 1 month to 15 years (median, 9.5 months). The mean Lysholm score significantly improved from 43.6 preoperatively to 87.5 postoperatively ( P <.001). Excellent or good outcome was accomplished in 25 of the patients (83%). Using the IKDC assessment, 26 of the patients (87%) reported their knee as being normal or nearly normal. Repeat arthroscopy with needle biopsy of the graft was performed in 9 patients. Seven of these had complete healing and 2 partial healing. The histologic examination revealed viable chondrocytes and normal hyaline cartilage in the completely healed cases. Congruency of the articular surface was restored in 11 of 12 patients (92%) who underwent magnetic resonance imaging examination. Abnormal marrow signal in the subchondral bone beneath the region of cartilage repair was present in 9 of 12 patients (75%), even 4 years after the procedure.


CONCLUSIONS
Arthroscopic AOT is an effective and safe method of treating symptomatic full-thickness chondral defects of the femoral condyles in appropriately selected cases. However, further studies with long-term follow-up are needed to determine if the grafted area will maintain structural and functional integrity over time.


METHODS
Level IV, therapeutic, case series (no, or historical, control group).
Chow
James C Y
JC
Orthopaedic Center of Southern Illinois, Mt. Vernon, Illinois 62864, USA.
Hantes
Michael E
ME
Houle
Jean Benoit
JB
Zalavras
Charalampos G
CG
D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D016025:Bone Transplantation / Q000379:methods*; D002358:Cartilage, Articular / Q000473:pathology / Q000601:surgery / Q000637:transplantation*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010008:Osteochondritis Dissecans / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D024162:Second-Look Surgery; D020858:Tissue and Organ Harvesting / Q000295:instrumentation / Q000379:methods; D014182:Transplantation, Autologous; D016896:Treatment Outcome