The morbidity associated with osteochondral harvest from asymptomatic knees for the treatment of osteochondral lesions of the talus.
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.
Reddy
Sudheer
S
Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA 19104, USA.
Pedowitz
David I
DI
Parekh
Selene G
SG
Sennett
Brian J
BJ
Okereke
Enyi
E
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