Osteochondral autograft transplantation for osteochondritis dissecans of the knee. Preliminary results of a prospective case series.
To evaluate the short-term outcome of osteochondritis dissecans (OCD) treated with mosaic osteochondral autograft transplantation (OAT), 7 male patients (mean age 33.4) with 8 OCD lesions on the lateral border of the medial femoral condyle were prospectively followed. Patients were evaluated by the International Knee Documention Committee (IKDC) score and the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaires preoperatively, at 6 months and 1 year after surgery. MRI evaluation using the modified Sanders score was performed at 1-year follow-up. The IKDC subjective score and all subscales of the KOOS improved significantly. MRI evaluation showed good surface congruency, no oedema or protuberance of the osteocartilaginous cylinders, good similarity of cartilage thickness and a non-complete osseous integration. With the small numbers of patients available, no correlation could be found between MRI findings, percentage of defect coverage and patient satisfaction. Mosaic OAT appeared in this study as a valid treatment option in selected cartilage defects. OCD lesions improved significantly following osteochondral transplantation. The limitations of this technique are the number and size of the plugs needed to repair the defect. Future research should focus on identifying the appropriate choice of operative treatment for well defined subtypes of articular cartilage lesions, rather than searching for one superior technique for all.
Smolders
José M H
JM
Department of Orthopaedic Surgery, Rijnstate Hospital, Arnhem, The Netherlands.
Kock
Niels B
NB
Koëter
Sander
S
Van Susante
Job L C
JL
D002356:Cartilage / Q000637:transplantation*; D002358:Cartilage, Articular / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D010008:Osteochondritis Dissecans / Q000473:pathology / Q000601:surgery*; D014182:Transplantation, Autologous; D016896:Treatment Outcome