Return to sports after autogenous osteochondral mosaicplasty of the femoral condyles: 25 cases at a mean follow-up of 9 years

Abstract

IntroductionAutogenous osteochondral mosaicplasty is the most common cartilage restoration technique in standard clinical practice. The purpose of this study was to evaluate the return to sports 9 years after mosaicplasty of the femoral condyles. HypothesisThe long-term results of an osteochondral autograft show that patients can regain their pre-injury activity level. Material and methodsThis study is based on a series of 25 patients with a mean age of 28.9 years (range, 16–44 years) who had stage 3 or 4 chondral lesions of the femoral condyles (according to the ICRS or ICRS-OCD scores). The origin of the lesion was osteochondritis dissecans (13 knees), osteochondral fracture sequelae (ten knees), or aseptic osteonecrosis (two knees). The average size of the lesion was 2.11±0.9 cm2. Ten patients (40%) had an associated procedure during the osteochondral autograft. The patients were assessed clinically (IKDC and Lysholm-Tegner scores) and radiographically by a reviewer independent of the team of operators. ResultsAll patients were re-examined at a mean follow-up of 9 years (range, 6–15 years), with 84% satisfied or very satisfied with the procedure. The average IKDC was 74.5±18.5 points. The average Lysholm score was 87.3±11.6 points. The average Tegner score ranged from 6.35±1.53 points prior to surgery to 5.60±1.64 points after surgery (P=0.001). The average loss was 0.64 points for patients whose presurgery Tegner score was greater than or equal to 7 (P=0.019) and 0.3 points if lower than 7. The radiologic evaluation of 21 patients showed complete osteointegration of the grafts in 90% of cases. ConclusionThe results of the femoral condyle mosaic autografts are satisfactory, a mean of 9 years after surgery. The most active patients lowered their activity level while the more sedentary did not have to adapt their lifestyle. Level of evidenceLevel IV, retrospective study.