title: Open Versus Arthroscopic Mosaicplasty of the Knee: A Cadaveric Assessment of Accuracy of Graft Placement Using Navigation.
abstract: OBJECTIVE
  The purpose of this study was to compare an open freehand mosaicplasty technique with an arthroscopic technique for the treatment of osteochondral lesions by measuring the instrument deviation, quantifying this deviation, and providing numerical information on the difference in the outcomes of these techniques.
  
  
  METHODS
  Four cadaveric knees were used. Reference markers were attached to the femur, tibia, and donor/recipient site guides. A total of 10 osteochondral grafts were harvested and inserted into recipient sites arthroscopically and 10 similar grafts were inserted freehand. The angles of graft removal and placement were calculated for each of the surgical groups compared. Ostensibly, a navigation system was used as an aid, to measure the graft placement parameters.
  
  
  RESULTS
  Statistical analysis revealed that there was no statistically significant difference between the arthroscopic method and the freehand method regarding the angle of graft removal at the donor site (P = .162), recipient site plug removal angle (P = .731), and recipient site graft placement angle (P = .630). In the freehand group, the mean angle of graft removal at the donor site was 12°, the mean angle of recipient site plug removal was 10.7°, and the mean angle of recipient site plug placement was 10.6°. Using the arthroscopic technique, the mean angle of graft removal at the donor site was 17.14°, the mean angle of recipient site plug removal was 12.0°, and the mean angle of recipient site graft placement was 10.14°.
  
  
  CONCLUSIONS
  Our study revealed there was no statistically significant difference regarding precision and accuracy during harvesting, recipient site preparation, and plug placement between the 2 techniques.
  
  
  CONCLUSIONS
  Controversy exists whether an open or arthroscopic osteoarticular transfer system (OATS) technique provides superior accuracy. According to our results, there is no statistically significant difference regarding better visualization, precision, and accuracy between the freehand and arthroscopic techniques. However, larger number of specimens are required for study.
authors.affiliation: Orthopaedic Department ULB, Medical School University of Brussels, University Hospital Erasme Brussels, Brussels, Belgium. Electronic address: jimkoul@yahoo.com.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Koulalis
authors.affiliation: Orthopaedic Surgeon, Athens, Greece.
authors.forename: Nikolaos A
authors.initials: NA
authors.lastname: Stavropoulos
authors.affiliation: Department of Orthopaedic Surgery, Helios ENDO Klinik Hamburg, Hamburg, Germany.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Citak
authors.affiliation: Clinic of Orthopedics, Azienda Ospedaliero-Universitaria of Udine, Udine, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Di Benedetto
authors.affiliation: Cappagh National Orthopaedic Hospital, Dublin, Ireland.
authors.forename: Padhraig
authors.initials: P
authors.lastname: O'Loughlin
authors.affiliation: Department of Orthopaedic Surgery, Shoulder and Sports Medicine Service, Hospital for Special Surgery, New York, New York, U.S.A.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Pearle
authors.affiliation: Department of Orthopaedic Surgery, Helios ENDO Klinik Hamburg, Hamburg, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Kendoff
mesh_terms: D001182:Arthroscopy / Q000379:methods*; D001696:Biomechanical Phenomena; D016025:Bone Transplantation / Q000379:methods; D002102:Cadaver; D005269:Femur / Q000601:surgery*; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D013977:Tibia / Q000601:surgery*; D019737:Transplants