Treatment of cartilage defects with autologous osteochondral grafts in the knee joint

Abstract

The treatment of full-thickness cartilage defects still poses problems. One of the currently applied methods to cover defects in the knee joint is osteochondral autografting. The purpose of this prospective study was to assess the outcome of this surgical treatment. Between August 1996 and July 1999, osteochondral transplantation was performed in 38 patients (mean age 37 years). The size of the lesion varied from 1.5 cm2 to 6.5 cm2. Before the operation the patients had suffered symptoms for an average of 15 months. Osteochondral grafts were harvested from the non-weight-bearing area of the femoral condyle. Patients were evaluated at a mean follow-up of 36 (range 23–58) months. The review protocol included clinical examination, X-ray, and magnetic resonance imaging (MRI). For comparative evaluation the HSS (Hospital for Special Surgery), Lysholm and Tegner activity scores were used. In 86% of the patients studied results were rated good or excellent. There were no infection, thrombophlebitis, or evidence of graft loosening. We conclude autologous osteochondral transplantation is an efficacious and valid one-step repair of the localized damaged articular surface of the knee. Nevertheless, in the future, studies with longer follow-ups and comparison with other forms of biologic resurfacing will be necessary.