Osteochondral autografts can be used to treat full-thickness
cartilage defects. In 1985, we reported two cases of osteochondral autograft
transplantation with the goal of repairing osteochondral defects in the knee
joints of patients with osteochondritis dissecans using hyaline cartilage. Since
then, osteochondral autograft transplantation, mosaicplasty, autologous
chondrocyte transplantation, and allogeneic osteochondral transplantation have
been developed and implemented as treatments for osteochondral defects.
However, the long-term outcomes of these treatment modalities have not been
hitherto reported.
The patient was a 21-year-old man. He had medial extended
type left knee joint osteochondritis dissecans osteochondral autograft
transplantation was performed in 1980. The osteochondral defect measured 28 ×
20 × 7 mm (length × width × depth) and extended anteroposteriorly from the
center of the medial femoral condyle (MFC) to the intercondylar fossa. A piece
of osteochondral autograft was collected from the medial side of the trochlea
and transplanted to the crater. Cancellous bone with cortical bone was
transplanted from the ilium to the osteochondral collection site.
There were neither subjective symptoms nor abnormal
objective findings in the knee 38 years after. Radiographs showed small osteophytes
in the medial tibiofemoral joint, and the patella skyline view showed a
narrowing of the medial patellofemoral joint space. On computed tomography, the
bony part of the transplanted osteochondral autograft was fused with the
surrounding bone tissue, and the trabecular pattern was similar to that of the
original bone. A coronal section of a magnetic resonance imaging scan showed
that the signal intensity of the transplanted cartilage was similar to that of
the adjacent native cartilage. In the patellofemoral joint, the cartilage of
the medial facet of the patella and trochlea was uneven.
We reported 38-year outcomes in a patient who underwent
osteochondral autograft transplantation in the knee joint. There were neither
subjective symptoms nor abnormal objective findings in the knee. Imaging
findings showed that a piece of osteochondral autograft filled the crater in
the femoral condyle, and the superficial cartilage was considered to be alive.
The osteochondral margin of the trochlea should have been
left when collecting the large graft from the trochlea. Further long-term
follow-up is required.
Author(s) Details
Fumiharu Yamashita
Department of Orthopedic Surgery, Kyoto Shimogamo Hospital,
Higashimorigamae-cho 17, Shimogamo, akyo, Kyoto, Japan.
Please see the link:- https://doi.org/10.9734/bpi/mmrnp/v1/1374
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