Background: The cartilage is a complex and specialized tissue. It is extremely difficult to repair or to replace it, once damaged. The management of cartilage defects remains controversial and over the last five decades various treatment options and surgical techniques have been tried to optimize the clinical outcome.
Objective: The aim of this study is to evaluate, but not to compare the results of two of the most used cartilage repair techniques: trans-chondral drilling and osteochondral autografting.
Material and methods: Between January 2009 and June 2010, we performed 55 transchondral drillings and 10 mosaicplasties on patients with articular cartilage defects of the knee. All patients were followed up at 6 months. Hughston clinical and radiological scales were used to evaluate the patients in the transchondral drilling group.
Results: The Hughston Clinic score was 2 in 2 cases (3.6%), 3 in 5 cases (9.9%) and 4 in 48 cases (86.5%), giving over 95% of good results. The Hughston radiological score was 2 in one case (2%), 3 in 4 cases (7.3%) and 4 in 50 cases (90.7%). In the mosaicplasty group,the average area of the osteochondral lesion covered with autologous osteochondral transplantation ranged from 0.8 to 6 cm2 (average: 2.13 cm2). The diameter of the grafts used ranged from 6 to 10 mm and 1 to 6 grafts were used in each case to achieve >90% covering of the lesion area.
Conclusions: Both techniques offer satisfactory functional outcome and do not compromise the patients’ future options.
Transchondral Drilling and Osteochondral Autografting (Mosaicplasty) in Knee Articular Cartilage Defects
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