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Study reveals long-term results of autologous osteochondral transplantation
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SAN DIEGO — Arthroscopic mosaicplasty and open autologous osteochondral transplantation were associated with reliable long-term outcomes when used to reconstruct full-thickness chondral and osteochondral lesions of the knee, however results with each procedure yielded a few failures at different follow-up times, according to recently presented research.
“With the treatment with mosaicplasty, we have failures at short-term; and if we use the open technique with massive osteoarticular transplants, we have failures at long-term,” Maurilio Marcacci, MD, of Bologna, Italy, said during his presentation at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons.
Marcacci and colleagues enrolled 30 patients with full-thickness chondral lesions in the mosaicplasty arm of the study and 13 patients with chondral and osteochondral lesions in the autologous osteochondral transplantation arm of the study. They evaluated 25 patients in the mosaicplasty group at a minimum follow-up of 11 years and 13 patients in the transplantation group at a minimum follow-up of 15 years. Investigators prospectively evaluated the patients’ results based on their activity levels with the Tegner score and other outcome measures. They also analyzed radiographic outcomes at final follow-up.
Three failures occurred in the mosaicplasty group, and four failures occurred in the transplantation group.
Patients in both groups showed similar improvements based on their IKDC scores and had significantly improved Tegner results at final follow-up, according to the study data. Post-treatment improvements in range of motion in both groups were less substantial than expected and probably due to some of the patients’ advanced age, according to Marcacci.
The size of the lesions treated were up to 5 cm2, Marcacci noted. He and his colleagues have since changed their indications for these procedures, he said during the paper discussion. “I think the indication is for 2.5 cm2 to 3.0 cm2 when you can use one or two plugs.”
Increased radiographic degeneration directly correlated to a higher number of plugs used with the procedures, Marcacci added.
Reference:
- Kon E, Patella S, Filardo G, et al. Autologous osteochondral transplantation: Long-term outcomes and joint degeneration progression. Paper #198. Presented at the 2011 Annual Meeting of the American Academy of Orthopaedic Surgeons. Feb. 15-19, 2011. San Diego.
Disclosure: He has no relevant financial disclosures.
