A Comparison of Clinical Outcomes after Osteochondral Autologous Transplantation & Arthroscopic Microfracture Surgery for Treating of Osteochondral Lesions of the Knee

Dong Chul Lee; Ook Jin Sohn; Min Chul Sung

doi:10.4055/jkoa.2009.44.3.320

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Lee, Sohn, and Sung: A Comparison of Clinical Outcomes after Osteochondral Autologous Transplantation & Arthroscopic Microfracture Surgery for Treating of Osteochondral Lesions of the Knee

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2009; 44(3): 320-328.

Published online: 18 June 2009

DOI: https://doi.org/10.4055/jkoa.2009.44.3.320

A Comparison of Clinical Outcomes after Osteochondral Autologous Transplantation & Arthroscopic Microfracture Surgery for Treating of Osteochondral Lesions of the Knee

Dong Chul Lee, M.D., Ook Jin Sohn, M.D., Min Chul Sung, M.D.

Department of Orthopedic Surgery, College of Medicine, Yeugnam University Hospital, Deagu, Korea.

Address reprint requests to Ook Jin Sohn, M.D. Department of Orthopedic Surgery, College of Medicine, Yeugnam University Hospital, 317-1, Daemyoung-dong, Nam-gu, Deagu 705-717, Korea. Tel: +82.53-620-3647, Fax: +82.53-628-4020, ossoj@med.yu.ac.kr

Abstract

Purpose

We wanted to compare the clinical outcomes after osteochondral autologous transplantation (OAT) and arthroscopic microfracture for treating of osteochondral lesions of the knee.

Materials and Methods

We reviewed 12 cases (12 patients) of arthroscopic microfracture and 10 cases (9 patients) of OAT. The mean patient ages were 33.5 years in the microfracture group and 31.3 years in the OAT group. The mean follow-up period was 31.1 months. The mean lesion sizes were 12.9×17.4 mm in the microfracture group and 16.1×21.4 mm in the OAT group. We compared clinical results using the Tegner activity score, the Lysholm knee scoring scale, the IKDC and the VAS. MRI was used to determine the recovery of the osteochondral lesions at last follow-up.

Results

There was no statistically significant difference between the groups for the Tegner Activity Score. Regarding the Lysholm Knee Scoring Scale, the OAT group had a better overall score than did the microfracture group (p<0.05). Both groups had similar results for the IKDC and VAS. The MRI at the last follow-up showed cartilage recovery in 53% of the microfracture cases (compared to the surrounding cartilage) and in 96.1% of the OAT cases.

Conclusion

Microfracture and OAT both offered good clinical results when used to treat active persons in the 3rd or 4th decades of life and who have osteochondral lesions of the knee. However, OAT led to better cartilage recovery on MRI, as well as to better functional results. Therefore, OAT is the recommended method of treatment.

Keywords: Osteochondral lesion, Osteochondral autologous transplantation, Microfracture

Figures and Tables

Fig. 1

Locations of osteochondral lesions using the ICRS knee cartilage lesion mapping system.

Fig. 2

Arthroscopic findings of 35 aged male patients. (A) Pre-operative arthroscopic finding, (B, C, D) Post-microfracture arthroscopic finding.

Fig. 3

Arthroscopic findings of 30 aged male patients. (A, B) Preoperative arthroscopic finding, (C) Post-osteochondral autologous transplantation arthroscopic finding.

Fig. 4

Cartilage thickness and degrees of osteochondral lesion healing (a, b: cartilage thickness). ^*Healing degree (%)=a/b×100.

Fig. 5

MRI revealed a gap between the lesion and the surrounding cartilage in a 35-year-old woman at 32 months after microfracture.

Fig. 6

MRI at 50 months after OAT showed well covered cartilage.

Fig. 7

MRI at 38 months after microfracture showed poorly covered cartilage.

Table 1

A Size of Osteochondral Lesions

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