Autologous osteochondral mosaicplasty in osteochondritis dissecans of the patella in adolescents.
Osteochondritis dissecans of the patella (OCDP) is rare in adolescents. The objective of this study was to evaluate functional results of OCDP management in adolescents with mosaicplasty and to analyze proper integration of osteochondral grafts via MRI.



This is a retrospective series of eight cases of OCDP treated by mosaicplasty. Mean age at the surgery was 15 years (range 12-17). Clinical features were represented by retropatellar pain, hydarthrosis, locking and crepitus. All patients benefited from knee radiographs as well as pre-operative MRI. Six OCDP were evaluated International Cartilage Repair Society (ICRS) grade III and two were ICRS grade IV. Mean surface of the lesion was 97.5 mm2. The pre- and post-operative assessments were conducted with scores obtained on the IKDC subjective knee evaluation form, Lysholm knee score, and Tegner activity scale. These assessments were completed by post-operative MRI. The magnetic resonance observation of cartilage repair tissue (MOCART) score was calculated from the latest MRI examination conducted after surgery.



Mean follow-up was 28.6 months. At the latest follow-up, the mean IKDC score was 86.5, Lysholm score was 89, and Tegner activity scale score was 6.2 (pre-operative scores were respectively 49.9, 53.8, and 4.5). Radiographs and MRI showed a complete integration of grafts at the latest follow-up with a satisfactory reconstruction of the joint surface. Mean MOCART score was 75/100.



Autologous osteochondral mosaicplasty to manage OCDP in adolescents appears to be a reliable technique on the short term to restore patellar joint surface and obtain satisfactory functional results.
Orthopaedic Pediatric Surgery Department, University Hospital of Montpellier, Montpellier, France.
Lamine
L
Chadli
Orthopaedic Pediatric Surgery Department, University Hospital of Montpellier, Montpellier, France. jerome.cottalorda@gmail.com.|Service d'Orthopédie Infantile, Hôpital Lapeyronie, 371 avenue du Doyen Gaston Giraud, 34295, Montpellier, Cedex 5, France. jerome.cottalorda@gmail.com.
Jérôme
J
Cottalorda
Orthopaedic Pediatric Surgery Department, University Hospital of Montpellier, Montpellier, France.
Marion
M
Delpont
Orthopaedic Pediatric Surgery Department, University Hospital of Montpellier, Montpellier, France.
Philippe
P
Mazeau
Pediatric Radiology Department, University Hospital of Montpellier, Montpellier, France.
Yann
Y
Thouvenin
Orthopaedic Pediatric Surgery Department, University Hospital of Montpellier, Montpellier, France.
Djamel
D
Louahem
D000293:Adolescent; D016025:Bone Transplantation / Q000379:methods*; D002358:Cartilage, Articular / Q000601:surgery; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D057072:Intra-Articular Fractures; D007719:Knee Joint / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D010008:Osteochondritis Dissecans / Q000601:surgery*; D010329:Patella / Q000601:surgery*; D012189:Retrospective Studies; D014182:Transplantation, Autologous; D016896:Treatment Outcome
Adolescent; Mosaicplasty; Osteochondritis dissecans; Patella