Abstract
Objective Focal osteochondral lesions of the knee are found in two thirds of patients undergoing
arthroscopy; their treatment, when isolated and especially in young individuals, remains
a debating topic. The present study analyzes the results obtained by the application
of the mosaicplasty technique on the treatment of isolated knee femoral condyle osteochondral
lesions.
Methods Retrospective study of patients submitted to mosaicplasty and to subjective analyses
with pre- and postsurgery International Knee Documentation Committee (IKDC) scores.
Results A total of 13 cases with an average age of 34 years old, with male patients (n = 4; 31%) with an average age of 23 years old (range: 17–31 years old), and female
patients (n = 9; 69%) with an average age of 39 years old (range: 16–56 years old); medial versus
lateral femoral (n = 11; 85% versus n = 2; 15%); the average size of the lesion was 1.8 cm2 (range: 0.6–4 cm2); average follow-up time: 5.045 ± 3.47 years (range: 1.15–11.01 years). The average
preoperative IKDC score was of 31.63 points (±20.24), the average postoperative IKDC
score was of 74.18 points (±20.26). The difference between the post- and preoperative
IKDC scores was of 42.55 (±21.05) points, being the minimal score increase of 8.1
points and the maximum score increase of 82.8 points. A statistically significant
difference (p < 0.001) was found between the IKDC scores before and after the surgery. A statistically
significant relation (p = 0.038) was found between the IKDC score increase (the difference between the postoperative
and the preoperative scores) and the dimension of the lesion.
Conclusions Mosaicplasty with osteochondral autograft transfer, when adequately used, can produce
excellent results with great durability and functional impact, low morbidity rates
and costs. Expansion of the indication criteria shows promising mid-term and long-term
results.
Keywords
osteochondritis/diagnosis - osteochondritis/surgery - arthroscopy - knee joint - cartilage,
articular
