Autologous osteochondral grafts in the treatment of cartilage defects of the knee joint

Abstract

Autologous osteochondral grafting (mosaicplasty) was performed on 18 patients with grade IV cartilage defects of the knee joint. The average age of these 12 men and 6 women was 36 years, follow-up time was 27.2 months and defect size was 252 mm(2) (18 x 14 mm). After plain anteroposterior and lateral radiographs and MRI (STIR sequence) examination, diagnostic arthroscopy was performed, followed by autologous osteochondral grafting, avoidance of weight bearing for 6-8 weeks, physiotherapy and continuous passive motion. All patients showed, radiologically (MRI), a full coverage of the defect with articular surface congruity postoperatively. The postoperative ICRS score was normal for 12 and nearly normal for 6 patients. Seven patients showed early persistent joint effusion for an average of 5.3 months. Hyaline-like cartilage coverage was found in four patients on second-look arthroscopy. The transplantation of autologous osteochondral grafts is being applied in an effort to reconstruct the affected articular surface with properties similar to those of hyaline cartilage. This method retains the integrity and function of a damaged joint, providing promising results in terms of preventing the development of early arthritis in young patients.

Cartilage repair with osteochondral autografts in sheep: Effect of biophysical stimulation with pulsed electromagnetic fields

“…It is a one-stage, low-cost procedure that can be performed either arthroscopically or by open technique, and good experimental and clinical results have been reported without risks of disease transmission. 15,[38][39][40][41] Concerns still exist about donor site morbidity and, concerning the graft, about cartilage integration and survival, and cyst formation in the subchondral bone, which may lead to graft instability and failure in the long-term. 39,42 To limit these problems, surgical procedure is of extreme importance in order to provide as much stability as possible to the graft (graft sizing, congruency), to reduce cartilage damage during surgical harvesting and surgical insertion, and to control the inflammatory response due to surgery.…”

Cartilage imaging: motivation, techniques, current and future significance

“…New surgical techniques that are available to treat focal cartilage lesions include mosaicplasty, microfracture, drilling procedures and autologous chondrocyte implantation [1][2][3]. Mosaicplasty, also termed osteochondral autograft transplantation (OAT) or autologous osteochondral transplantation, is one of the most promising techniques that has been developed [4][5][6].…”

Normal and pathological MR findings in osteochondral autografts with longitudinal follow-up

“…A number of new surgical techniques are now available and have revolutionized the therapy of focal cartilage lesions [1][2][3]. One of the most promising techniques that has evolved is osteochondral autograft transplantation [4][5][6][7][8][9][10]; a number of synonyms have been used for this technique, including mosaicplasty, osteochondral autograft transfer system (OATS) and autologous osteochondral transplantation (AOT).…”

“…Thus the objectives of this study were (1) to assess normal MR findings in patients after osteochondral autograft transplantation, (2) to analyze pathological findings and (3) to correlate clinical and MR-findings in these patients.…”