[Treatment of osteochondritis dissecans of the knee: one-step procedure with bone grafting and matrix-supported autologous chondrocyte transplantation].
OBJECTIVE
The aim of this study was to establish and assess a one-step reconstruction procedure of deep osteochondral defects of the knee joint with bone grafting and matrix-supported autologous chondrocyte transplantation in osteochondritis dissecans.


METHODS
Between 2004 and 200622 patients with osteochondral defects in the weight-bearing zone of the femoral condyles(ICRS OCD III and IV) were reconstructed simultaneously with bone grafting and matrix-supported autologous chondrocyte transplantation (NOVOCART 3D). All patients were analysed prospectively.


RESULTS
17 Males and 5 females(age 28.3, range: 17-49 years) were surgically treated with the above-mentioned novel method. Before reconstruction osteochondral defects had an average defect area of 4.8 (2.4-9.0) cm2 and a depth of between 4 and 15 mm. For reconstruction an average of 2.6 (1-6) monocortical cancellous bone cylinders (diameter 8mm) was used to fill the osseous defect and to reconstruct the subchondral bone plate with adequate positioning of the monocortical layer of the graft. Then a Matrix-ACT was used to cover the reconstructed subchondral bone plate. The average follow-up was 16 (6-36) months. The average Tegner activity score was 4 (3-7) of 10. The Lysholm-Gillquistscore and the Cincinnati Sports Medicine and Orthopedic Center score were significantly improved postoperatively. The IKDC-2000 questionnaire was also significantly increased by 50%.


CONCLUSIONS
The simultaneous reconstruction of deep osteochondral detects of the knee joint with bone grafting and matrix-supported autologous chondrocyte transplantation in osteochondritis dissecans is a biological, one-step alternative to previously reported methods with encouraging first results.
Ochs
B G
BG
Berufsgenossenschaftliche Unfallklinik Tübingen, Tübingen.
Müller-Horvat
C
C
Rolauffs
B
B
Fritz
J
J
Weise
K
K
Schewe
B
B
D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation / Q000379:methods*; D019902:Chondrocytes / Q000637:transplantation*; D003094:Collagen / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005109:Extracellular Matrix / Q000637:transplantation; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010008:Osteochondritis Dissecans / Q000601:surgery*; D023822:Tissue Engineering / Q000379:methods*; D016896:Treatment Outcome
D003094:Collagen