Results at 10 to 14 years after osteochondral autografting (mosaicplasty) in articular cartilage defects in the knee

Abstract

Purpose: The aim of this study was to evaluate the medium-term (5-9 years) and long-term (10-14 years) outcomes of mosaicplasty in the knee and identify possible risk factors for poor outcome.

Methods: We included patients 60 years or younger with symptomatic focal full-thickness chondral lesions. Seventy-three patients (87%) with median age of 34 years were available for analyses. Clinical outcome was evaluated by Lysholm score and VAS of pain.

Results: Both the mean Lysholm score and mean VAS pain score improved significantly from baseline, 49 (SD 17) and 58 (SD 23), respectively, to both the mid-term follow-up, 72 (SD18, p<0.001) and 27 (SD 20, p<0.001), respectively, and the long-term follow-up, 72 (SD 21, p<0.001) and 33 (SD 23, p<0.001), respectively. A poor outcome at the long-term follow-up - defined as a Lysholm score of 64 or less or having had a knee replacement - was found in 40%. A poor outcome was more frequent in patients 40 years or older (59%), in women (61%) and in defects with an area of 3 cm(2) or more (57%). Conversely, in a subgroup of male individuals younger than 40 years with defect size less than 3 cm(2) the failure rate was 12.5% and the mean Lysholm score was 82 (SD 16).

Conclusion: We conclude that the long-term clinical outcome after mosaicplasty varies greatly depending on age, gender and the size of the lesion.

Level of evidence: IV-Retrospective Case Series.