title: The morbidity associated with osteochondral harvest from asymptomatic knees for the treatment of osteochondral lesions of the talus.
abstract: BACKGROUND
  Mosaic autogenous osteochondral transplantation has been used to treat large osteochondral defects.
  
  
  OBJECTIVE
  There is potential, previously unrecognized donor-site morbidity associated with osteochondral harvest from asymptomatic knees for the treatment of talar osteochondral defect lesions.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  Fifteen patients underwent mosaic osteochondral transplantation to treat a talar osteochondral defect lesion, with 11 patients available for follow-up. A Lysholm knee score was used to assess donor-site morbidity at a mean follow-up of 47 months (range, 7-77 months). Mean age was 29 years (range, 21-44 years). A single surgical team performed the mosaicplasties. Significance was determined using the Student t test.
  
  
  RESULTS
  All patients had asymptomatic knees preoperatively. Mean postoperative Lysholm score was 81 (range, 49-100). By Lysholm criteria, 5 rated as excellent, 2 as good, and 4 as poor. No significant difference was detected in terms of the harvest method or the number of grafts obtained from those having an excellent rating versus those having a good/poor rating. Patients rated as good/poor cited knee instability in daily activities as the most common problem. One had knee pain and patellar instability after osteochondral harvest by lateral arthrotomy that required a subsequent lateral retinacular release and tibial tubercle osteotomy.
  
  
  CONCLUSIONS
  This study demonstrates that donor-site morbidity after osteochondral harvest can be significant. In this population, those who experienced a decline in knee function had problems performing activities of daily living. When performing these procedures, the authors recommend that surgeons consider these risks and discuss them with their patients.
authors.affiliation: Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA 19104, USA.
authors.forename: Sudheer
authors.initials: S
authors.lastname: Reddy
authors.forename: David I
authors.initials: DI
authors.lastname: Pedowitz
authors.forename: Selene G
authors.initials: SG
authors.lastname: Parekh
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Sennett
authors.forename: Enyi
authors.initials: E
authors.lastname: Okereke
mesh_terms: D000328:Adult; D001182:Arthroscopy; D005260:Female; D005269:Femur / Q000637:transplantation*; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010007:Osteochondritis / Q000601:surgery*; D012189:Retrospective Studies; D013628:Talus / Q000473:pathology / Q000601:surgery*; D014182:Transplantation, Autologous; D016896:Treatment Outcome