Article

Autogenous osteochondral mosaicplasty is the most common cartilage
restoration technique in standard clinical practice. The purpose of this study
was to evaluate the return to sports 9 years after mosaicplasty of the femoral
condyles. HYPOTHESIS: The long-term results of an osteochondral autograft show
that patients can regain their pre-injury activity level.
This study is based on a series of 25 patients with a mean age of 28.9 years
(range, 16-44 years) who had stage 3 or 4 chondral lesions of the femoral
condyles (according to the ICRS or ICRS-OCD scores). The origin of the lesion was
osteochondritis dissecans (13 knees), osteochondral fracture sequelae (ten
knees), or aseptic osteonecrosis (two knees). The average size of the lesion was
2.11+/-0.9 cm(2). Ten patients (40%) had an associated procedure during the
osteochondral autograft. The patients were assessed clinically (IKDC and
Lysholm-Tegner scores) and radiographically by a reviewer independent of the team
of operators. RESULTS: All patients were re-examined at a mean follow-up of 9
years (range, 6-15 years), with 84% satisfied or very satisfied with the
procedure. The average IKDC was 74.5+/-18.5 points. The average Lysholm score was
87.3+/-11.6 points. The average Tegner score ranged from 6.35+/-1.53 points prior
to surgery to 5.60+/-1.64 points after surgery (P=0.001). The average loss was
0.64 points for patients whose presurgery Tegner score was greater than or equal
to 7 (P=0.019) and 0.3 points if lower than 7. The radiologic evaluation of 21
patients showed complete osteointegration of the grafts in 90% of cases.
CONCLUSION: The results of the femoral condyle mosaic autografts are
satisfactory, a mean of 9 years after surgery. The most active patients lowered
their activity level while the more sedentary did not have to adapt their
lifestyle. LEVEL OF EVIDENCE: Level IV, retrospective study.
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Langue : FRANCAIS