High-Grade Patellar Chondral Defects: Promising Results From Management With Osteochondral Autografts

Simple item page
dc.contributor.authorFigueroa, David
dc.contributor.authorCalvo, Rafael
dc.contributor.authorDonoso, Rodrigo
dc.contributor.authorEspinoza, Jaime
dc.contributor.authorVaisman, Alex
dc.contributor.authorYañez, Claudio
dc.date.accessioned2021-08-06T20:30:38Z
dc.date.available2021-08-06T20:30:38Z
dc.date.issued2020-07
dc.description.abstractBackground: Patellar chondral defects represent up to 34.6% of defects found during routine arthroscopy. Surgical management has evolved during the past 20 years in an effort to develop techniques to replace hyaline cartilage. Currently, the only technique that achieves this is osteochondral autologous transfer (OAT). Although good and excellent results have often been reported at midterm and long-term follow-up for femoral lesions, little is known about isolated patellar defects. Purpose: To assess clinical and imaging results of patients treated with OAT for high-grade patellar defects. Study Design: Case series; Level of evidence, 4. Methods: This was a retrospective study on all patients who received OAT for high-grade symptomatic patellar chondral defects between 2010 and 2018 at our institution. The study included patients younger than 40 years of age with anterior knee pain and a grade 4 International Cartilage Repair Society patellar chondral defect between 1 and 2.5 cm2. Patients with surgery in other knee compartments, concomitant anterior cruciate ligament ruptures, infection, rheumatoid arthritis, and degenerative lesions were excluded. Six months postoperatively, all patients underwent magnetic resonance imaging (MRI) to allow assessment of graft integrity via the MOCART (Magnetic Resonance Observation of Cartilage Repair Tissue) score to evaluate morphologic features and integration. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Kujala scores were used to assess functional outcomes at final follow-up. Results: A total of 26 patients who received a patellar OAT were included. Most patients were male (88.4%), and the mean ± SD age was 28.5 ± 9.7 years. Patellar chondral defects had a median size of 180 mm2 (range, 64-250 mm2), and patients received a median of 1 autograft (range, 1-3). Functional outcomes assessed at a minimum of 1 year after surgery showed a mean Kujala score of 90.42 ± 6.7 and a mean WOMAC score of 95 ± 3.6. MRI revealed a median MOCART score of 75 points (range, 20-90 points). Conclusion: To our knowledge, this is the largest series to date regarding isolated patellar OAT. At midterm follow-up, most patients reported good and excellent results regarding symptoms and activity levels. Most autografts showed good osseous integration and excellent filling of the chondral surface, as evidenced on MRI. OAT is a good alternative to treat high-grade patellar chondral defects, especially among young patients.es
dc.identifier.citationThe Orthopaedic Journal of Sports Medicine, 2020 vol. 8(7)es
dc.identifier.urihttps://doi.org/10.1177/2325967120933138es
dc.identifier.urihttp://hdl.handle.net/11447/4255
dc.language.isoenes
dc.subjectPatellaes
dc.subjectAutologouses
dc.subjectTransplantationes
dc.subjectOsteochondrales
dc.subjectChondrales
dc.subjectCartilagees
dc.titleHigh-Grade Patellar Chondral Defects: Promising Results From Management With Osteochondral Autograftses
dc.typeArticlees

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
High-Grade Patellar.pdf
Size:
352.53 KB
Format:
Adobe Portable Document Format
Description:
Texto completo
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description:
Download

Collections

Artículos Medicina y Ciencias de la Salud

Implementado por OpenGeek Services