Abstract
Summary Autologous osteochondral transplantation (mosaicplasty) fills articular surface defects with hyaline cartilage-like tissue to resurface the defected area. 96 high level athletes with full-thickness chondral defects were treated with mosaicplasty. Most of these defects (79 cases) were located in the knee, 15 in the talus and in 2 in the elbow capitellum. Osteoarthritic degenerative changes of Fairbank's grade I or II after were observed in 44% of the affected joints. The average size of the chondral defects in knees treated with mosaicplasty was an average 2 cm 2 (1–5.5 cm 2 ) but in 3 cases it exceeded 4 cm 2 . In the talus the mean defect size was 1.5 cm 2 (0.5–2.5 cm 2 ) while in the elbow capitellum the size of the two defects was 1cm 2 and 1.5 cm 2 . The mean follow-up time was 4.5 ± 3.1 years (range 1–10 years). The mean patients' age was 27 ± 6.5 years (range 14-39 years). There were 55 male and 41 female patients. In the knee defect group the mean modified HSS score preoperatively was 62 ± 19.5 (47–82) and at the last postoperative follow-up was 87 ± 18.9 (64–100) points. The mean preoperative Lysholm score was 66 ± 14.6 (49–84) and the last postoperative score was 91 ± 13.2 (68–100). In the talus defect group the mean preoperative Hanover score was 73 ± 12.4 (56–81) and the mean postoperative score was 92 ± 8.6 (84–102). The time to return to the desired level of sports activities averaged 4.2 ± 2.4 months (3–10 months). Sixty-seven out of 96 patients resumed the same level of athletic activity, 18% a lower level and 12% failed to return to sports activities. Only 8% of the athletes rated the post operative knee function and symptom scores as being worse than that recorded prior to mosaicplasty. Autologous osteochondral transplantation (mosaicplasty) provides favorable mid-term functional results in high level athletes even in those with radiographic evidence of osteoarthritic changes or those with large defects as a salvage procedure.
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