Autogenous osteochondral mosaicplasty is the most common cartilage restoration technique in standard clinical practice. The purpose of this study was to evaluate the return to sports 9 years after mosaicplasty of the femoral condyles.
The long-term results of an osteochondral autograft show that patients can regain their pre-injury activity level.
Material and methods
This study is based on a series of 25 patients with a mean age of 28.9 years (range, 16–44 years) who had stage 3 or 4 chondral lesions of the femoral condyles (according to the ICRS or ICRS-OCD scores). The origin of the lesion was osteochondritis dissecans (13 knees), osteochondral fracture sequelae (ten knees), or aseptic osteonecrosis (two knees). The average size of the lesion was 2.11±0.9 cm2. Ten patients (40%) had an associated procedure during the osteochondral autograft. The patients were assessed clinically (IKDC and Lysholm-Tegner scores) and radiographically by a reviewer independent of the team of operators.
All patients were re-examined at a mean follow-up of 9 years (range, 6–15 years), with 84% satisfied or very satisfied with the procedure. The average IKDC was 74.5±18.5 points. The average Lysholm score was 87.3±11.6 points. The average Tegner score ranged from 6.35±1.53 points prior to surgery to 5.60±1.64 points after surgery (P=0.001). The average loss was 0.64 points for patients whose presurgery Tegner score was greater than or equal to 7 (P=0.019) and 0.3 points if lower than 7. The radiologic evaluation of 21 patients showed complete osteointegration of the grafts in 90% of cases.
The results of the femoral condyle mosaic autografts are satisfactory, a mean of 9 years after surgery. The most active patients lowered their activity level while the more sedentary did not have to adapt their lifestyle.
Level of evidence
Level IV, retrospective study.Le texte complet de cet article est disponible en PDF.
Keywords : Autogenous osteochondral graft, Osteochondral lesion, Mosaicplasty, Femoral condyles, Condyle osteochondritis