Microfracture technique versus osteochondral autologous transplantation mosaicplasty in patients with articular chondral lesions of the knee: a prospective randomized trial with long-term follow-up.
OBJECTIVE
To compare long-term functional and radiological outcome following microfracture technique (MF) versus osteochondral autologous transplantation (OAT) mosaicplasty for treating focal chondral lesions of the knee.


METHODS
Twenty-five patients (mean age 32.3 years, SD 7.7) with a full-thickness (International Cartilage Repair Society grade 3 or 4) chondral lesion of the articulating surface of the femur were randomized to either MF (n = 11) or OAT mosaicplasty (n = 14). At a median follow-up of 9.8 years (range 4.9-11.4), the patients were evaluated using Lysholm score (n = 25), Knee Injury and Osteoarthritis Outcome Score (KOOS, n = 25), isokinetic quadriceps measurement and hamstring strength measurement (n = 22) and standing radiographs (n = 23).


RESULTS
There were no significant differences in Lysholm score, KOOS, isokinetic muscle strength or radiographic osteoarthritis between MF-treated patients and OAT mosaicplasty-treated patients at follow-up. Mean Lysholm score at follow-up was 69.7 [95% confidence interval (CI), 55.1-84.4] for the MF group and 62.6 (95% CI, 52.6-72.6) for the OAT mosaicplasty group.


CONCLUSIONS
At long-term follow-up, there were no significant differences between patients treated with MF and patients treated with OAT mosaicplasty in patient-reported outcomes, muscle strength or radiological outcome.


METHODS
Therapeutic study, Level II.
Department of Orthopedic Surgery, Akershus University Hospital, 1478, Lørenskog, Norway, svend.ulstein@ahus.no.
Svend
S
Ulstein
Asbjørn
A
Årøen
Jan Harald
JH
Røtterud
Sverre
S
Løken
Lars
L
Engebretsen
Stig
S
Heir
D000328:Adult; D054544:Arthroplasty, Subchondral; D002357:Cartilage Diseases / Q000601:surgery*; D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery*; D005260:Female; D005269:Femur / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007718:Knee Injuries / Q000601:surgery; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D011446:Prospective Studies; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult