BACKGROUND: Mosaic autogenous osteochondral transplantation has been used to treat large osteochondral defects. HYPOTHESIS: There is potential, previously unrecognized donor-site morbidity associated with osteochondral harvest from asymptomatic knees for the treatment of talar osteochondral defect lesions. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Fifteen patients underwent mosaic osteochondral transplantation to treat a talar osteochondral defect lesion, with 11 patients available for follow-up. A Lysholm knee score was used to assess donor-site morbidity at a mean follow-up of 47 months (range, 7-77 months). Mean age was 29 years (range, 21-44 years). A single surgical team performed the mosaicplasties. Significance was determined using the Student t test. RESULTS: All patients had asymptomatic knees preoperatively. Mean postoperative Lysholm score was 81 (range, 49-100). By Lysholm criteria, 5 rated as excellent, 2 as good, and 4 as poor. No significant difference was detected in terms of the harvest method or the number of grafts obtained from those having an excellent rating versus those having a good/poor rating. Patients rated as good/poor cited knee instability in daily activities as the most common problem. One had knee pain and patellar instability after osteochondral harvest by lateral arthrotomy that required a subsequent lateral retinacular release and tibial tubercle osteotomy. CONCLUSION: This study demonstrates that donor-site morbidity after osteochondral harvest can be significant. In this population, those who experienced a decline in knee function had problems performing activities of daily living. When performing these procedures, the authors recommend that surgeons consider these risks and discuss them with their patients.
BACKGROUND: Mosaic autogenous osteochondral transplantation has been used to treat large osteochondral defects. HYPOTHESIS: There is potential, previously unrecognized donor-site morbidity associated with osteochondral harvest from asymptomatic knees for the treatment of talar osteochondral defect lesions. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Fifteen patients underwent mosaic osteochondral transplantation to treat a talar osteochondral defect lesion, with 11 patients available for follow-up. A Lysholm knee score was used to assess donor-site morbidity at a mean follow-up of 47 months (range, 7-77 months). Mean age was 29 years (range, 21-44 years). A single surgical team performed the mosaicplasties. Significance was determined using the Student t test. RESULTS: All patients had asymptomatic knees preoperatively. Mean postoperative Lysholm score was 81 (range, 49-100). By Lysholm criteria, 5 rated as excellent, 2 as good, and 4 as poor. No significant difference was detected in terms of the harvest method or the number of grafts obtained from those having an excellent rating versus those having a good/poor rating. Patients rated as good/poor cited knee instability in daily activities as the most common problem. One had knee pain and patellar instability after osteochondral harvest by lateral arthrotomy that required a subsequent lateral retinacular release and tibial tubercle osteotomy. CONCLUSION: This study demonstrates that donor-site morbidity after osteochondral harvest can be significant. In this population, those who experienced a decline in knee function had problems performing activities of daily living. When performing these procedures, the authors recommend that surgeons consider these risks and discuss them with their patients.
Authors: João Espregueira-Mendes; Hélder Pereira; Nuno Sevivas; Pedro Varanda; Manuel Vieira da Silva; Alberto Monteiro; Joaquim M Oliveira; Rui L Reis Journal: Knee Surg Sports Traumatol Arthrosc Date: 2012-01-28 Impact factor: 4.342
Authors: Tomasz L Nosewicz; Mikel L Reilingh; Martin Wolny; C Niek van Dijk; Georg N Duda; Hanna Schell Journal: Knee Surg Sports Traumatol Arthrosc Date: 2013-03-12 Impact factor: 4.342
Authors: Kenneth W Ng; Eric G Lima; Liming Bian; Christopher J O'Conor; Prakash S Jayabalan; Aaron M Stoker; Keiichi Kuroki; Cristi R Cook; Gerard A Ateshian; James L Cook; Clark T Hung Journal: Tissue Eng Part A Date: 2010-03 Impact factor: 3.845
Authors: Maartje Zengerink; Peter A A Struijs; Johannes L Tol; Cornelis Niek van Dijk Journal: Knee Surg Sports Traumatol Arthrosc Date: 2009-10-27 Impact factor: 4.342