J Korean Orthop Assoc.  2016 Feb;51(1):69-76. 10.4055/jkoa.2016.51.1.69.

Treatment of Unstable Osteochondral Dissecans Lesion of the Knee Joint Using Autologous Osteochondral Plug

• Seo SS
• Seo JH
• Yi JW
• Jung DW
• Kim DH

• KMID: 2154351
• DOI: http://doi.org/10.4055/jkoa.2016.51.1.69

Abstract

PURPOSE
The purpose of this study was to evaluate the clinical results of fixation of the unstable osteochondral dissecans (OCD) lesion with autologous osteochondral plugs.
MATERIALS AND METHODS
This study was conducted in 19 patients who were relevant to the International Cartilage Repair Society 2, 3, or 4 who were treated with autologous osteochondral plugs and followed-up for more than 2 years from January 2004 to January 2012. Clinical evaluation was performed by comparing the preoperative and last follow-up scores of Lysholm score and subjective International Knee Documentation Committee (IKDC) score.
RESULTS
All patients were male and the average age was 19.1 years. Of the 19 cases, there were 16 cases of medial femoral condyle lateral side lesion, 2 cases of lateral femoral condyle articular surface, and 1 case of femoral intercondylar notch lesions. The average size of the lesion was 5.68 mm2, and average use of osteochodral plugs were 4.3. Average follow-up period was 38 months. Preoperative Lysholm score, IKDC subjective score showed significant improvement.
CONCLUSION
Fixation with autologous osteochondral plugs for unstable OCD uses the remnant tissues therefore conserving it, which is thought to be the positive aspect of this type of operation.

Keyword

knee; osteochondral dissecans; autologous osteochondral plug fixation

MeSH Terms

Cartilage
Follow-Up Studies
Humans
Knee Joint*
Knee*
Male

Figure

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  Figure 1 Mosaicplasty was performed and a osteochondral plug with 4.5 mm in diameter was collected and fixed at the center of the cartilage. To maintain stability an additional 4.5 mm or depending on the remnant surface, 3.5 mm or 2.7 mm osteochondral plug was fixed at the margins. LFC, lateral femoral condyle; MFC, medial femoral condyle.

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  Figure 2 A 4.5 mm drill was used to drill the subchondral bone sufficient enough for fixation.

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  Figure 3 A guide tube was used to insert the osteochondral plug to match the cartilage portion of the plug and the lesion.

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  Figure 4 The outer margin was firmly fixed with osteochondral plugs using the same method.

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  Figure 5 Complete healing state on 2nd look arthroscopic finding at 12 months follow-up.

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