title: Effectiveness and limitations of autologous osteochondral grafting for the treatment of articular cartilage defects in the knee.
abstract: OBJECTIVE
  To evaluate the effectiveness and limitations of autologous osteochondral grafting for the treatment of articular cartilage defects in the knee.
  
  
  METHODS
  The subjects were 40 patients who had undergone autologous osteochondral grafting. Fifteen knees had cartilage defects combined with anterior cruciate ligament tears (ACL group), 15 knees had cartilage defects combined with osteoarthritis (OA group), and 10 knees had cartilage defects combined with osteochondral dissecans (OCD group). From one to five osteochondral pegs were harvested from the less-weight-bearing periphery of the articular surface of the femoral condyle and grafted to cartilage defects. The clinical results were assessed based on the Lysholm score and radiographic and magnetic resonance imaging (MRI) image assessment.
  
  
  RESULTS
  The median follow-up duration was 24 months (range from 12 to 41 months). The mean Lysholm score following treatment was improved in all groups. The patients who had cartilage defects combined with OA had a significantly poorer prognosis than did those with cartilage defects combined with ACL or OCD. In the OA group, advanced stage and an alignment abnormality were correlated with poor prognosis. Advanced age was correlated with poor prognosis. Other parameters showed no significant difference in prognosis.
  
  
  CONCLUSIONS
  Autologous osteochondral grafting was found to be an effective technique for treating relatively young patients who had cartilage defects combined with ACL injury or OCD, but this technique showed limited results in treating cartilage defects based on advanced patient age and degenerative changes in the cartilage.
  
  
  METHODS
  Diagnostic studies-investigating a diagnostic test, Level III.
authors: Department of Orthopaedic Surgery, Shimane University School of Medicine, 89-1, Enya, Izumo, Shimane, 693-8501, Japan. imades@med.shimane-u.ac.jp
authors: Shinji
authors: S
authors: Imade
authors: Nobuyuki
authors: N
authors: Kumahashi
authors: Suguru
authors: S
authors: Kuwata
authors: Jyunji
authors: J
authors: Iwasa
authors: Yuji
authors: Y
authors: Uchio
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000070598:Anterior Cruciate Ligament Injuries; D001178:Arthroplasty / Q000379:methods*; D001182:Arthroscopy; D016025:Bone Transplantation; D002358:Cartilage, Articular / Q000293:injuries; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D051457:Hyaline Cartilage / Q000293:injuries / Q000637:transplantation*; D007718:Knee Injuries / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications; D010008:Osteochondritis Dissecans / Q000150:complications; D011183:Postoperative Complications; D012044:Regression Analysis; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult