Multiple osteochondral arthroscopic grafting (mosaicplasty) for cartilage defects of the knee: prospective study results at 2-year follow-up.
OBJECTIVE
To prospectively evaluate the mosaicplasty technique for treatment of femoral condyle cartilage lesions (Outerbridge grade IV) less than 2.5 cm2 in homogeneous group of young active patients.


METHODS
Case series.


METHODS
Thirty-seven patients (10 female, 27 male; mean age, 29.5 years) with full-thickness knee chondral lesions were treated by the arthroscopic mosaicplasty technique. All patients practiced sports. There were 12 ACL reconstructions, 11 medial meniscectomies, and 8 lateral meniscectomies associated; 10 meniscectomies, 9 ACL reconstructions, and 5 cartilage reparative operations had been previously performed. All patients were evaluated at a 2-year follow-up. The International Cartilage Repair Society (ICRS) form, return to sports, computed tomography, or magnetic resonance imaging were used for clinical evaluation. In some cases, second-look arthroscopy was performed.


RESULTS
The ICRS showed 78.3% good and excellent results; 27 patients returned to sports at the same level and 5 at a lower level, but 5 were not able to resume sports. Results in the lateral condyles were significantly better than those in medial condyles, and younger patients had a better clinical outcome than did older patients. Cases with associated surgery had better clinical results; previous surgery did not significantly influence the clinical outcome.


CONCLUSIONS
The results of this technique at medium-term follow-up are encouraging with 78.3% clinically satisfactory results. Better results can be obtained in young patients with associated surgery, with localized grade 4 lesions of the lateral condyles. This arthroscopic 1-step surgery appears to be a valid solution for the treatment of grade III-IV cartilage defects not more than 2.5 cm2.


METHODS
Level IV, Case Series.
Marcacci
Maurilio
M
Istituti Ortopedici Rizzoli, Bologna, Italy.
Kon
Elizaveta
E
Zaffagnini
Stefano
S
Iacono
Francesco
F
Neri
Maria Pia
MP
Vascellari
Alberto
A
Visani
Andrea
A
Russo
Alessandro
A
D000328:Adult; D001265:Athletic Injuries / Q000601:surgery*; D016025:Bone Transplantation / Q000379:methods; D002357:Cartilage Diseases / Q000534:rehabilitation / Q000601:surgery*; D002358:Cartilage, Articular / Q000033:anatomy & histology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000534:rehabilitation / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D018709:Statistics, Nonparametric; D013997:Time Factors; D014182:Transplantation, Autologous