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

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.