Cartilage defect of lunate facet of distal radius after fracture treated with osteochondral autograft from knee.
We describe using an osteochondral autograft from the lateral femoral condyle of the knee to treat a symptomatic die-punch lesion of the lunate facet of the distal radius. An 18-year-old woman who sustained a distal radius fracture remained symptomatic after nonoperative treatment and diagnostic wrist arthroscopy with microfracture. We used a commercial harvesting system to transfer an osteochondral plug into a cartilage defect involving the lunate facet of the distal radius. At final follow-up, 34 months after surgery, the patient was assessed with a visual analog scale (VAS) and Disabilities of the Arm, Shoulder, and Hand (DASH) scores and with a comprehensive physical examination. Magnetic resonance arthrogram was used to assess articular cartilage status. VAS pain score improved from 7 before surgery to 0.5 after surgery. Postoperative DASH score was 0. The patient was asymptomatic and had satisfactory wrist motion without mechanical symptoms. Magnetic resonance arthrogram showed the transferred osteochondral autograft incorporated in excellent position.
Sports Medicine Fellow, Division of Sports Medicine, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois. nathanmall@yahoo.com.
Nathan A
NA
Mall
David A
DA
Rubin
Robert H
RH
Brophy
Charles A
CA
Goldfarb
D000293:Adolescent; D064592:Autografts; D002356:Cartilage / Q000637:transplantation*; D005260:Female; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D012667:Lunate Bone / Q000601:surgery*; D011884:Radius / Q000293:injuries* / Q000601:surgery; D014182:Transplantation, Autologous; D016896:Treatment Outcome