Treatment of big osteochondral defects in the lateral femoral condyle in young patients with autologous graft and collagen mesh

Abstract

The treatment of massive osteochondral defects in young patients constitutes a challenge for the orthopaedic surgeon. On the one hand, facing the biological filling and on the other, guaranteeing the function in the short and long term. Defects in the lateral femoral condyle are extremely rare.We studied 7 cases of massive bone defects in the lateral condyle, 2 of them bilateral, with a median surface area of 6.8 cm2 (IQR: 4.9−7.0 cm2) and a median depth of 2.8 cm (IQR; 2.2–3.2 cm). The patients were between 17 and 21 years old, without any previous traumatic background and were treated with autologous iliac crest graft and collagen mesh (Cartmaix-Matricel). Pre and postoperative clinical (Lysholm, Tegner, Koos) and radiological tests (3d Mocart) have been carried out.Best improvement have seen in clinical parameters have been normalized in all patients, with a return to sports activities. Likewise, the radiological defect has been recovered in all of them, subtotally but more than 50%.Massive osteochondral defects in the lateral condyle could be treated by filling with autologous crest bone and a collagen mesh, with good clinical and radiological results, constituting a rational option in the therapeutic approach.