Autogenous Osteochondral Grafting for Treatment of Knee Osteochondritis Dissecans: A Case Series Study

Abstract

Background: Although some surgical techniques have been described for the operative treatment of unstable<br />Osteochondritis dissecans (OCD) of the knee, outcomes are variable and are not satisfying totally. The aim of the<br />present study is to evaluate the outcomes of autogenous osteochondral grafting for OCD of the knee.<br />Methods: In a case series study, from June 2014 to July 2015, 16 patients with stage II-IV OCD (International Cartilage<br />Repair Society (ICRS)) of the femoral condyle were investigated. Surgical intervention considered in cases of stage III<br />(4 cases) and IV (2 cases) and in stage II (10 cases) ones that were nonresponsive to conservative treatment. At the<br />initial and final visits, the IKDC, Lysholm score and Tegner activity scale were evaluated.<br />Results: The mean preoperative IKDC score (53.4) increased significantly following surgery (84.3) (P<0.001).<br />Based on the IKDC grading system, before the operation, the knee status was graded as nearly normal, abnormal,<br />and severely abnormal in 4, 10, and 2 patients, respectively. At final post-surgical follow up, 15 normal and 1<br />abnormal knee were documented (P<0.001). The mean Lysholm score increased from 44.3 per operatively to 86.3<br />(P<0.001).Tegner activity score improved from 2.8±1 pre operatively to 5.6 ±2 (P<0.001).<br />Conclusion: Surgical treatment of unstable OCD using autogenous osteochondral graft shows successful outcomes.<br />In addition to reliable fixation, it can enhance healing and convert an uncontained lesion to contained one appropriate<br />for autogenous osteochondral grafting with healthy cartilage.<br />Level of evidence: IV