title: Arthroscopic mosaicplasty: long-term outcome and joint degeneration progression.
abstract: BACKGROUND
  This study aims to document the long-term results in a group of patients treated with arthroscopic mosaicplasty for knee cartilage lesions, both in terms of clinical outcome and joint degeneration progression, evaluated by radiographs.
  
  
  METHODS
  26 patients (19 men and 7 women, mean age 29 years, mean BMI 23) treated arthroscopically with mosaicplasty for cartilage defects of the femoral condyles (mean/median/mode size 1.9 standard deviation, SD 0.6 cm(2)) were prospectively evaluated at 12 years follow-up. The clinical outcome was analyzed with IKDC and Tegner scores. Range of motion, transpatellar and suprapatellar circumferences were also measured. Radiographs with weight-bearing antero-posterior and Rosenberg projections were used for radiological evaluation in 18 patients, applying both Kellgren-Lawrence score and a direct joint line measurement to assess osteoarthritis.
  
  
  RESULTS
  A significant improvement in all clinical scores was obtained from the basal evaluation to the 12-year follow-up (IKDC subjective score from 36.8 standard deviation, SD 13.0 to 77.3 standard deviation, SD 20.6, P<0.0005; Tegner score from 2.9 standard deviation, SD 1.3 to 5.2 standard deviation, SD 2.5, P<0.0005), and better results in patients with a higher pre-injury activity level and those requiring fewer plugs. The radiographic evaluation showed significantly poorer Kellgren-Lawrence scores and a reduction of the joint line in the treated compartments. Knees with 3-4 plugs presented a significantly higher joint degeneration level with respect to those implanted with 1-2 plugs.
  
  
  CONCLUSIONS
  Mosaicplasty is an effective surgical option for small lesions of the femoral condyles. Although joint degeneration progression was present at 12 years, this did not affect significantly the clinical outcome which was satisfactory at long-term follow-up.
authors.affiliation: Biomechanics Laboratory, II Orthopaedics and Traumatology Clinic, Rizzoli Orthopaedic Institute, Bologna, Italy. Electronic address: g.filardo@biomec.ior.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Filardo
authors.affiliation: Biomechanics Laboratory, II Orthopaedics and Traumatology Clinic, Rizzoli Orthopaedic Institute, Bologna, Italy. Electronic address: e.kon@biomec.ior.it.
authors.forename: Elizaveta
authors.initials: E
authors.lastname: Kon
authors.affiliation: Biomechanics Laboratory, II Orthopaedics and Traumatology Clinic, Rizzoli Orthopaedic Institute, Bologna, Italy. Electronic address: francescoperdisa@gmail.com.
authors.forename: Francesco
authors.initials: F
authors.lastname: Perdisa
authors.affiliation: Radiology and Diagnostic Imaging Department, Rizzoli Orthopaedic Institute, Bologna, Italy. Electronic address: cecilia.tetta@ior.it.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Tetta
authors.affiliation: Biomechanics Laboratory, II Orthopaedics and Traumatology Clinic, Rizzoli Orthopaedic Institute, Bologna, Italy. Electronic address: a.dimartino@biomec.ior.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Di Martino
authors.affiliation: Biomechanics Laboratory, II Orthopaedics and Traumatology Clinic, Rizzoli Orthopaedic Institute, Bologna, Italy. Electronic address: m.marcacci@biomec.ior.it.
authors.forename: Maurilio
authors.initials: M
authors.lastname: Marcacci
mesh_terms: D000328:Adult; D054544:Arthroplasty, Subchondral / Q000379:methods*; D001182:Arthroscopy / Q000379:methods*; D002357:Cartilage Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery*; D005260:Female; D006801:Humans; D051457:Hyaline Cartilage / Q000637:transplantation*; D007718:Knee Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D011859:Radiography; D016059:Range of Motion, Articular; D016896:Treatment Outcome
keywords: Autograft; Joint degeneration; Knee; Long-term; Mosaicplasty