Primary Stability of Osteochondral Grafts Used in Mosaicplasty

Kordas, Geza; Szabó, J; Hangody, László

doi:10.1016/j.arthro.2005.12.011

Cited by 45 publications

(53 citation statements)

References 28 publications

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“…Duchow et al (2000) performed some tests on the use of different plug lengths and diameters and found significant differences, but they only tested the pull-out strength of the plugs, which-clinically-seems to us to be of less importance than the push-through force. More recently, Kordas et al (2005) reported that bottomed plugs were more stable than unbottomed ones, but only a few groups were compared. They also suggested that if plugs were bottomed, a recipient site would result in higher impaction forces to get the (relatively longer) plug at flush level.…”

Section: Interpretation Of Resultsmentioning

confidence: 99%

Press-fit stability of an osteochondral autograft: Influence of different plug length and perfect depth alignment

et al. 2006

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Background Osteochondral autologous transplantation is used for the treatment of full-thickness articular cartilage lesions of a joint. Press-fit stability is an important factor for good survival of the transplanted plugs.Material and methods 36 plugs of three different lengths were transplanted in fresh-frozen human knees. On one condyle, 3 plugs were exactly matched to the depth of the recipient site ("bottomed" plugs) and on the opposite condyle 3 plugs were 5 mm shorter than the depth of the recipient site ("unbottomed" plugs). Plugs were left protruding and then pushed in until flush, and then to 2 mm below flush level, using a loading apparatus.Results Longer plugs needed higher forces to begin displacement. At flush level, bottomed plugs needed significantly higher forces than unbottomed plugs to become displaced below flush level (mean forces of 404 N and 131 N, respectively). Shorter bottomed plugs required higher forces than longer bottomed ones.Interpretation Bottomed plugs generally provide much more stability than unbottomed ones. Short bottomed plugs are more stable than long bottomed plugs. Thus, in clinical practice it is advisable to use short bottomed plugs. If, however, unbottomed plugs are still chosen, the longer the plug the higher the resulting stability will be because of higher frictional forces.

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Section: Interpretation Of Resultsmentioning

confidence: 99%

Press-fit stability of an osteochondral autograft: Influence of different plug length and perfect depth alignment

et al. 2006

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“…Smaller-sized plugs may be able to fill irregular defects with possibly less donor site morbidity [17]. Nevertheless, smaller grafts are more fragile; have lower pullout strength; and technically, they are more labor-demanding and difficult to harvest and implant [19]. These facts should be considered for subsequent refinement of the technique.…”

Section: Discussionmentioning

confidence: 99%

Osteochondral transplantation using autografts from the upper tibio-fibular joint for the treatment of knee cartilage lesions

Espregueira-Mendes

Pereira

Sevivas

et al. 2012

Knee Surg Sports Traumatol Arthrosc

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Purpose Treatment of large cartilage lesions of the knee in weight-bearing areas is still a controversy and challenging topic. Autologous osteochondral mosaicplasty has proven to be a valid option for treatment but donor site morbidity with most frequently used autografts remains a source of concern. This study aims to assess clinical results and safety profile of autologous osteochondral graft from the upper tibio-fibular joint applied to reconstruct symptomatic osteochondral lesions of the knee. Methods Thirty-one patients (22 men and 9 women) with grade 4 cartilage lesions in the knee were operated by mosaicplasty technique using autologous osteochondral graft from the upper tibio-fibular joint, between 1998 and 2006. Clinical assessment included visual analog scale (VAS) for pain and Lysholm score. All patients were evaluated by MRI pre-and post-operatively regarding joint congruency as good, fair (inferior to 1 mm incongruence), and poor (incongruence higher than 1 mm registered in any frame). Donor zone status was evaluated according to specific protocol considering upper tibio-fibular joint instability, pain, neurological complications, lateral collateral ligament insufficiency, or ankle complaints. Results Mean age at surgery was 30.1 years (SD 12.2). In respect to lesion sites, 22 were located in weight-bearing area of medial femoral condyle, 7 in lateral femoral condyle, 1 in trochlea, and 1 in patella. Mean follow-up was 110.1 months (SD 23.2). Mean area of lesion was 3.3 cm 2 (SD 1.7), and a variable number of cylinders were used, mean 2.5 (SD 1.3). Mean VAS score improved from 47.1 (SD 10.1) to 20.0 (SD 11.5); p = 0.00. Similarly, mean Lysholm score increased from 45.7 (SD 4.5) to 85.3 (SD 7.0); p = 0.00. The level of patient satisfaction was evaluated, and 28 patients declared to be satisfied/very satisfied and would do surgery again, while 3 declared as unsatisfied with the procedure and would not submit to surgery again. These three patients had lower clinical scores and kept complaints related to the original problem but unrelated to donor zone. MRI score significantly improved at 18-24 months comparing with pre-operative (p = 0.004). No radiographic or clinical complications related to donor zone with implication in activity were registered. Conclusions This work corroborates that mosaicplasty technique using autologous osteochondral graft from the upper tibio-fibular joint is effective to treat osteochondral defects in the knee joint. No relevant complications related to donor zone were registered. Level of evidence Case series, Level IV.

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“…It was shown that larger grafts are more stable in absolute values, and multiple grafts may not be as stable as single grafts in the initial period following transplantation. [21] Therefore, restriction of weight-bearing is recommended for a certain period of time following mosaicplasty to avoid graft subsidence, until bony integration occurs.…”

Section: Mosaicplastymentioning

confidence: 99%

Clinical experiences with cartilage repair techniques: outcomes, indications, contraindications and rehabilitation

Berta

Duska

Tóth

et al. 2015

Eklem Hastalik Cerrahisi

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Primary Stability of Osteochondral Grafts Used in Mosaicplasty

Cited by 45 publications

References 28 publications

Press-fit stability of an osteochondral autograft: Influence of different plug length and perfect depth alignment

Press-fit stability of an osteochondral autograft: Influence of different plug length and perfect depth alignment

Osteochondral transplantation using autografts from the upper tibio-fibular joint for the treatment of knee cartilage lesions

Clinical experiences with cartilage repair techniques: outcomes, indications, contraindications and rehabilitation

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