Eirik Solheim1, Janne Hegna2, Eivind Inderhaug3. 1. Department of Orthopedics, Deaconess University Hospital, Haraldsplass, Bergen, Norway; Department of Orthopedics, Aleris Nesttun Hospital, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway. Electronic address: eirik.solheim@uib.no. 2. Department of Orthopedics, Aleris Nesttun Hospital, Bergen, Norway. 3. Department of Orthopedics, Deaconess University Hospital, Haraldsplass, Bergen, Norway; Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
Abstract
BACKGROUND: The purpose of this study was to evaluate the outcome after cartilage repair surgery in focal defects of the knee by microfracture versus mosaicplasty. METHODS: A cohort of 102 patients undergoing microfracture (n=52) or mosaicplasty (n=50) of a single articular cartilage defect in the medial femoral condyle of ≤50mm2 was evaluated by Lysholm score before surgery, at six months, 12months, five years, 10years, and 15-18years after surgery. RESULTS: Median age of patients at the time of surgery was 36years (range 16-58) and median follow-up time was 16years (range 14-18). Defects were treated with a median size of three square centimetres (range one to five). A significant increase was seen in the Lysholm score from mean 48 (SD 16) at baseline to 66 (SD 23; P<0.001) at the 15-18year follow-up. The Lysholm score was higher in the mosaicplasty group at six months, 12months, five years and 10years (P<0.05 for all comparisons). These differences were clinically significant at all points (>10 points). However, at the final follow-up, the difference (eight points) did not reach statistical significance. CONCLUSIONS: In the short-term, medium-term and long-term (10years), mosaicplasty in a single cartilage defect size one to five square centimetres of the femoral condyle resulted in clinically relevant better outcome than microfracture. However, at 15-18years after the surgery such a difference could not be found. In the six month to 10-15year (after surgery) perspective, the mosaicplasty procedure offered a better outcome in this type of lesion. LEVEL OF EVIDENCE: Level III.
BACKGROUND: The purpose of this study was to evaluate the outcome after cartilage repair surgery in focal defects of the knee by microfracture versus mosaicplasty. METHODS: A cohort of 102 patients undergoing microfracture (n=52) or mosaicplasty (n=50) of a single articular cartilage defect in the medial femoral condyle of ≤50mm2 was evaluated by Lysholm score before surgery, at six months, 12months, five years, 10years, and 15-18years after surgery. RESULTS: Median age of patients at the time of surgery was 36years (range 16-58) and median follow-up time was 16years (range 14-18). Defects were treated with a median size of three square centimetres (range one to five). A significant increase was seen in the Lysholm score from mean 48 (SD 16) at baseline to 66 (SD 23; P<0.001) at the 15-18year follow-up. The Lysholm score was higher in the mosaicplasty group at six months, 12months, five years and 10years (P<0.05 for all comparisons). These differences were clinically significant at all points (>10 points). However, at the final follow-up, the difference (eight points) did not reach statistical significance. CONCLUSIONS: In the short-term, medium-term and long-term (10years), mosaicplasty in a single cartilage defect size one to five square centimetres of the femoral condyle resulted in clinically relevant better outcome than microfracture. However, at 15-18years after the surgery such a difference could not be found. In the six month to 10-15year (after surgery) perspective, the mosaicplasty procedure offered a better outcome in this type of lesion. LEVEL OF EVIDENCE: Level III.
Authors: Bryan Michael Saltzman; Michael L Redondo; Adam Beer; Eric J Cotter; Rachel M Frank; Adam B Yanke; Brian J Cole Journal: Cartilage Date: 2018-10-31 Impact factor: 4.634