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Osteochondral autografting (mosaicplasty) in grade IV cartilage defects in the knee joint: 2- to 7-year results

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Abstract

The use of autologous osteochondral grafts (mosaicplasty) to repair articular cartilage defects is a well-established technique. Between 1998 and 2003, 19 patients with grade IV cartilage defects in the knee joint were treated by mosaicplasty. The average age of these 13 men (68%) and six women (32%) was 33.1 years (20–46). The mean follow-up was 32.4 months (84–24). The mean preoperative and postoperative Lysholm score was 45.8 (21–60) and 87.5 (74–100), respectively (p<0.001). Postoperative evaluation showed significant improvement. The results at the last follow-up were excellent in seven patients (27%), good in 11 patients (58%) and fair in one patient (15%). Preoperative complaints of pain, crepitation and locking disappeared in all patients. Magnetic resonance imaging (MRI) examination at the last follow-up visit revealed that congruency was restored in 16 (84.2%) without any signs of fissuring or delamination but in three patients (15.8%) a 1-mm difference between graft and recipient surface was detected. No complications were observed in the patients. Mosaicplasty is a really effective method of treatment for grade IV cartilage lesions in the knee joint.

Résumé

La technique de la mosaïc–plastie utilisant des greffes ostéocartilagineuses autologues pour réparer les dommages articulaires est une technique actuellement bien établie. Entre 1998 et 2003, 19 patients avec des lésions cartilagineuse de grade IV au niveau de l’articulation du genou, ont été traités par mosaïc–plastie. L’âge moyen de cette population (13 hommes 68% et 6 femmes 32%) était de 33,1 ans (20–46), le suivi moyen a été de 32,4 mois (84–24). Le score de Lysholm pré–op et post–op a été de 45,8 (21–60) et 87,5 (74–100) (p<0,001). L’évaluation post–opératoire a montré une amélioration significative, avec un résultat excellent chez 7 patients (27%), bon chez 11 patients (58%) et médiocre chez 1 patient (15%). La symptomatologie préopératoire (douleurs, craquements et blocages) a disparu chez tous les patients. L’examen IRM au dernier contrôle a montré que la cicatrisation était bien restaurée chez 16 patients (84.2%), sans signe de fissuration ni de délamination mais avec, chez 3 patients (15,8%) une différence d’un millimètre entre la greffe et le site receveur. Aucune complication n’a été observée chez ces patients. La mosaïc–plastie est une technique sûre et efficace du traitement des lésions cartilagineuses de grade IV au niveau du genou.

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  1. Clinic of Orthopaedics and Traumatology Bursa High Speciality, Research and Education Hospital, Yildirim, Bursa, Turkey

    Alpaslan Oztürk, M. Recai Ozdemir & Yüksel Ozkan

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  1. Alpaslan Oztürk
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  2. M. Recai Ozdemir
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  3. Yüksel Ozkan
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Correspondence to Alpaslan Oztürk.

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Oztürk, A., Ozdemir, M.R. & Ozkan, Y. Osteochondral autografting (mosaicplasty) in grade IV cartilage defects in the knee joint: 2- to 7-year results. International Orthopaedics (SICO 30, 200–204 (2006). https://doi.org/10.1007/s00264-005-0068-5

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