Management of Osteochondral Defects in the Knee via Osteochondral Autograft Plug Transfer: An Assessment of the Short-term Results

Faculty Medicine Year: 2021
Type of Publication: ZU Hosted Pages:
Authors:
Journal: Egyptian orthopaedic Journa Egyptian orthopaedic Journa Volume:
Keywords : Management , Osteochondral Defects , , Knee via Osteochondral Autograft    
Abstract:
Abstract Background: The treatment of articular cartilage knee defects is challenging because of its avascular nature and poor access to regenerative stem cells, which limits the healing potential under continuous mechanical loading. Aim of the work: This study aims to assess the short-term results (minimum of 2 years follow-up) of osteochondral autograft plug transfer (OAPT) as a surgical treatment method for osteochondral defects (OCD) in the knee articular femoral surface. Patients and Methods: This prospective study was conducted on 21 patients (15 males and six females; mean age, 28.95 years; age range, 16 –39 years) with OCD in the cartilage of the femoral condyle in the knee. The procedures were conducted at the Zagazig University hospital between January 2017 and April 2019 using the OAPT technique. Osteochondral plugs were harvested and transferred using the miniopen arthrotomy technique according to the lesion size and accessibility. The mean follow-up period was 25.4 ± 1.2 months. Data were gathered throughout the study period, and the outcomes were assessed at the last visit clinically and radiologically using plain radiographs and magnetic resonance images. Results: OCD was observed in the lateral and medial femoral condyles in five (23.8%) and 16 (76.2%) patients, respectively. The sizes of the lesions ranged from 1 to 5 cm² (mean, 3.14 cm²). The clinical outcome evaluation included the Lysholm score, which improved from 45.6 to 91.1, and the pain score using the visual analog scale, which improved from 6.5 to 1.09. Only two patients presented with hemarthrosis postoperatively and required aspiration with no long-term drawbacks. Conclusion: OAPT was found to be an effective and reproducible option for the surgical treatment of OCD on the femoral articular surface of the knee, with satisfactory short-term outcomes. Age, sex, size of the lesion, and concomitant knee surgery were the major prognostic elements, whereas the site of the lesion, follow-up period, and etiology (traumatic or nontraumatic) did not affect the outcome. Keywords: Osteochondral autograft, plug transfer, OCD, Osteochondral defect, Knee.
   
     
 
       

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