36. Second Look Arthroscopic Finding After Osteochondral Autograft Transfter for the Treatment of Chondral Defect of the Knee
Nam-Hong Choi, M.D.
Department of Orthopaedic Surgery, Nowon Eulji Medical Center, Eulji Medical College, Seoul, Korea
INTRODUCTION
A variety of methods have potentials to stimulate the formation of new articular surface ; multiple drilling, microfracture, perichondral graft, chondrocyte transplantation, and ostoechondral graft transplantation. Among these methods, osteochondral graft transplantation has the advantages of providing a fully formed articular cartilage matrix and also restoring subchondral bone. The purpose of this prospective study was to evaluate second look arthroscopic finding after osteochondral autograft transfer(OAT) for the treatment of chondral defect of the knee.
MATERIALS and METHODS
Since March, 1997, forty cases underwent OAT for the treatment of chondral defect of the knee. Fourteen out of forty cases underwent second look arthroscopy. There were eleven male and three female. The average age of patients at OAT was 34 years. The causes of chondral defect were sports in seven, idiopathic in five, and slip in two cases. The average duration of symptom was three years and six months. Preoperatively, magnetic resonance imag- ing was performed in eleven cases and chondral defect was suspected in nine cases. Combined procedures were three meniscal resection, two anterior cruciate ligament reconstruction, one posterior cruciate ligament reconstruction, one meniscal repair, one high tibial osteotomy, and one meniscal transplantation. The site of chondral defect located at medial femoral condyle at seven, trochlea in four, and lateral femoral condyle in three cases. The average size of con- dral defect was 13×10mm, maximum 22×20mm. The number of graft was one in eight, two in three, three in two, and five in one case. Postoperatively, when the lesion located at weight bearing area, immediate partial weight bear- ing and active range of motion were permitted. After six weeks, full range of motion was permitted.
RESULTS
Follow-up periods ranged from four years to seven months, average twenty-one months. Second look arthroscopy was performed at six months in almost cases. The grafted cartilage was firm and well incorporated with surrounding cartilage in eleven cases. In two cases, grafted cartilage was slightly soft, but well incorporated with surrounding car- tilage. In one case, grafted cartilage was firm, but not well incorporated with surrounding cartilage.
DISCUSSION
Because the durability of resurfaced cartilage depends on physical property, the consistency and incorporation with surrounding cartilage of resurfaced cartilage were very important. After OAT, 86% cases showed that grafted carti- lage was firm and 93% cases showed that grafted cartilage was well incorporated with surrounding cartilage. This study has limitation of lack of histological and mechanical property study. OAT is an alternative of treatment of chondral defect the knee.
[ 44 ] Korean Knee Society
