Functional outcome after arthroscopic mosaicplasty for localized osteochondral defects in the knee
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20241114Keywords:
Mosaicplasty, Arthroscopy, Osteochondral defectAbstract
Background: Articular cartilage is complex tissue that is able to withstand tremendous amount of force over many cycle but does not have the ability to heal even after minor injury. Treatment recommendation for articular cartilage injury and arthritis includes non-operative and operative management. Mosaicplasty is a reconstructive osteochondral grafting procedure for the treatment of articular defects of the knee. Mosaicplasty entails transplantation of small cylindrical osteochondral grafts from the non-weight bearing area of the femoral condyles and transplanting them in a mosaic like fashion into a prepared defect site on the weight-bearing surfaces of the same knee.
Methods: The present study was carried out in 30 patients in our hospital prospectively to determine the functional outcome results after arthroscopic mosaicplasty for localized osteochondral defects in the knee. We conducted a prospective study on 30 patients of osteochondral defect of knee. Patients were presented with pain and recurrent swelling in the knee after sustaining twisting injury in the knee. Diagnostic arthroscopy was done and the osteochondral defects is localized and treated with mosaicplasty. The graft is harvested arthoscopically from the non-weight bearing part of the femoral condyles using a harvester. Follow up of these patients is done according to Tenger Lysholm knee scoring scale at 03 months, 06 months after surgery.
Results: In our study 93.33% patients showed good to excellent results and 7% patients had fair and poor results.
Conclusions: Advantage of arthroscopic mosaicplasty includes implantation of hyaline cartilage without the need for any suture or adhesive, need for smaller incision minimally invasive and very less complications. Associated injuries like ACL/PCL or meniscal tear can be addressed in the same procedure. To conclude arthroscopic mosaicplasty is excellent procedure to address the focal articular cartilage injuries of knee.
References
Dell'accio F, Vincent TL. Joint surface defects: clinical course and cellular response in spontaneous and experimental lesions. EUR Cell Mater. 2010;20:210-7.
Hill CL. Knee effusions, popliteal cysts, and synovial thickening: association with knee pain in osteoarthritis. J Rheumatol. 2001;28(6):1330-37.
Alford JW, Cole BJ, Cartilage restoration, part 1 basic science, historical perspective, patient evaluation, and treatment options. Am J Sports Med. 2005;33(2):295-306.
Feczko P, Varga J, Bartha L, Lajos B, Zoltán D, Gabor B, et al. Experimental results of donor site filling for autologous osteochondral mosaicplasty. Arthroscopy J Arthroscopic Related Surg. 2003;19(7):755-61.
Hangody L, Rathonyi GK, Duska Z, Varsarshelyi G, Fules P, Modis L. Autologous osteochondral mosaicplasty. Surgical technique. J Bone Joint Surg. 2004;86(1):65-72.
Nho SJ, Foo LF, Green DM, Shindle MK, Warren RF, Wickiewicz TL, et al. Magnetic resonance imaging and clinical evaluation of patellar resurfacing with press fit osteochondral autograft plugs. Am J Sports Med. 2008;36(6):1101-9.
Farr J, Cole B, Dhawan A, Kercher J, Sherman S. Cartilage restoration evolution and Overview. Clin Ortho Relat Res. 2011;469(10):2696-705.
Ivănescu A, Melinte R, Sólyom Á, Moraru L, Petrișor M, Brânzaniuc K. Transchondral Drilling and Osteochondral Autografting (Mosaicplasty) in Knee Articular Cartilage Defects. Acta Medica Marisiensis. 2011;57(4):303-5.
Garretson RB, Katolic LI, Beck PR, Bach BR, Cole BJ. Contact pressure at osteochondral donor sites in the patellofemoral joint. Am J Sports Med. 2004;32(4):967-74.
Ahmad CS, Cohen ZA, Levine WN, Ateshian GA, Mow VC. Biomechanical and topographic considerations for autologous osteochondral grafting in the knee. Am J Sports Med. 2001;29(2):201-6.
Bartz RL, Kamaric E, Noble PC, Lintner D, Bocell J. Topographic matching of selected donor and recipient sites for osteochondral grafting of the articular surface of the femoral condyle. Am J Sports Med. 2001;29(2):207-12.
Horas U, Pelinkovic D, Herr G, Aigner T, Schnettler R. Autologous chondrocyte implantation and osteochondral cylinder transplantation in cartilage repair of the knee joint. A prospective, comparative trial. J Bone Joint Surg (Am). 2003;85(2):185-92.
Dozin B, Malpeli M, Cancedda R, Bruzzi P, Calcagno S, Molfetta L, et al. Comparative evaluation of autologous chondrocyte implantation and mosaicplasty: a multicentered randomized clinical trial. Clin J Sport Med. 2005;15(4):220-6.