Comparison of arthroscopic osteochondral autologous transplantation for articular cartilage injury in young and middle-aged patients_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

PAN Yangyang , CHEN Jiwei , FENG Hai , XU Jiazhen ,  MENG Ye

Department of Orthopedic Surgery and Sports Medicine, Qingdao Municipal Hospital, the Affiliated Hospital of Qingdao University, Qingdao Shandong, 266071, P.R.China;

Corresponding author：

MENG Ye, Email: 1027138327@qq.com

Keywords：

cartilage injury; osteochondral autologous transplantation; arthroscopy; cartilage repair; youth; middle age

DOI：

10.7507/1002-1892.201808124

Video：

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Objective To compare the effectiveness of arthroscopic osteochondral autologous transplantation (OAT) in the treatment of young and middle-aged patients with the articular cartilage injury. Methods A clinical data of 43 patients (43 knees) with articular cartilage injury, who underwent OAT between January 2008 and August 2016, was retrospectively analyzed. There were 23 patients aged 20-40 years (young group) and 20 patients aged 40-60 years (middle-aged group). The difference in age between the two groups was significant (t=14.120, P=0.001). There was no significant difference in gender, body mass index, complications, affected side, lesion site, lesion area, and the International Cartilage Repair Society (ICRS) grade of cartilage injury between the two groups (P>0.05). The function of knee joint was evaluated by Lysholm score and International Knee Documentation Committee (IKDC) score during the follow-up. MRI examination was performed to observe the repair of both receiving and the donor sites. Results All the incisions in the two groups were healed by first intention. All patients in the two groups were followed up with an average of 3.6 years (range, 2-8 years). At 2 years after operation, the Lysholm and IKDC scores were significantly improved in the two groups when compared with the preoperative scores (P<0.05). The Lysholm and IKDC scores in the young group were significantly better than those in the middle-aged group before operation and at 2 years after operation (P<0.05). However, there was no significant difference in the differences of the Lysholm and IKDC scores between pre- and post-operation between the two groups (P>0.05). The MRI examination at 2 years after operation showed that both receiving and the donor sites healed well in the two groups. Conclusion According to the texture, thickness, elasticity, and lesion area of the cartilage, arthroscopic OAT might be the first choice for the articular cartilage injury in middle-aged patients and can obtain the satisfactory short-term effectiveness.

Citation： PAN Yangyang, CHEN Jiwei, FENG Hai, XU Jiazhen, MENG Ye. Comparison of arthroscopic osteochondral autologous transplantation for articular cartilage injury in young and middle-aged patients. Chinese Journal of Reparative and Reconstructive Surgery, 2019, 33(2): 154-159. doi: 10.7507/1002-1892.201808124 Copy

1.	Curl WW, Krome J, Gordon ES, et al. Cartilage injuries: a review of 31,516 knee arthroscopies. Arthroscopy, 1997, 13(4): 456-460.
2.	Hjelle K, Solheim E, Strand T, et al. Articular cartilage defects in 1,000 knee arthroscopies. Arthroscopy, 2002, 18(7): 730-734.
3.	Shelbourne KD, Jari S, Gray T. Outcome of untreated traumatic articular cartilage defects of the knee: a natural history study. J Bone Joint Surg (Am), 2003, 85-A(Suppl 2): 8-16.
4.	Varela-Eirin M, Loureiro J, Fonseca E, et al. Cartilage regeneration and ageing: Targeting cellular plasticity in osteoarthritis. Ageing Res Rev, 2018, 42: 56-71.
5.	黄志刚, 王耀, 马克. 低氧诱导因子1α基因在大鼠终板软骨细胞中的表达及意义研究. 中国修复重建外科杂志, 2017, 31(3): 103-108.
6.	桑伟林, 姜亚飞, 程飚, 等. 硬化蛋白在内翻畸形膝关节内外侧胫骨平台软骨下骨中的表达差异及其意义. 中国修复重建外科杂志, 2017, 31(3): 47-51.
7.	Haien Z, Jiachang W, Qiang L, et al. Osteochondral autologous transplantation compared to microfracture for treating osteochondral defect: An updated meta-analysis of randomized controlled trials. J Knee Surg, 2017, 31(4): 341-347.
8.	Krych AJ, Harnly HW, Rodeo SA, et al. Activity levels are higher after osteochondral autograft transfer mosaicplasty than after microfracture for articular cartilage defects of the knee: a retrospective comparative study. J Bone Joint Surg (Am), 2012, 94(11): 971-978.
9.	Gudas R, Gudaité A, Mickevičius T, et al. Comparison of osteochondral autologous transplantation, microfracture, or debridement techniques in articular cartilage lesions associated with anterior cruciate ligament injury: a prospective study with a 3-year follow-up. Arthroscopy, 2013, 29(1): 89-97.
10.	Shimozono Y, Hurley ET, Nguyen JT, et al. Allograft compared with autograft in osteochondral transplantation for the treatment of osteochondral lesions of the talus. J Bone Joint Surg (Am), 2018, 100(21): 1838-1844.
11.	Sherman SL, Thyssen E, Nuelle CW. Osteochondral autologous transplantation. Clin Sports Med, 2017, 36(3): 489-500.
12.	Haddo O, Mahroof S, Higgs D, et al. The use of chondrogide membrane in autologous chondrocyte implantation. Knee, 2004, 11(1): 51-55.
13.	Gross AE. Repair of cartilage defects in the knee. J Knee Surg, 2002, 15(3): 167-169.
14.	Robert H. Chondral repair of the knee joint using mosaicplasty. Orthop Traumatol Surg Res, 2011, 97(4): 418-429.
15.	Matsusue Y, Yamamuro T, Hama H. Arthroscopic multiple osteochondral transplantation to the chondral defect in the knee associated with anterior cruciate ligament disruption. Arthroscopy, 1993, 9(3): 318-321.
16.	Richter DL, Tanksley JA, Miller MD. Osteochondral autograft transplantation: A review of the surgical technique and outcomes. Sports Med Arthrosc Rev, 2016, 24(2): 74-78.
17.	Tanaka Y, Mima H, Yonetani Y, et al. Histological evaluation of spontaneous osteonecrosis of the medial femoral condyle and short-term clinical results of osteochondral autografting: a case series. Knee, 2009, 16(2): 130-135.
18.	Frisbie DD, Oxford JT, Southwood L, et al. Early events in cartilage repair after subchondral bone microfracture. Clin Orthop Relat Res, 2003, (407): 215-227.
19.	Solheim E, Hegna J, Oyen J, et al. Osteochondral autografting (mosaicplasty) in articular cartilage defects in the knee: results at 5 to 9 years. Knee, 2010, 17(1): 84-87.
20.	Solheim E, Hegna J, Strand T, et al. Randomized study of long-term (15-17 years) outcome after microfracture versus mosaicplasty in knee articular cartilage defects. Am J Sports Med, 2018, 46(4): 826-831.
21.	Lynch TS, Patel RM, Benedick A, et al. Systematic review of autogenous osteochondral transplant outcomes. Arthroscopy, 2015, 31(4): 746-754.
22.	Yabumoto H, Nakagawa Y, Mukai S, et al. Osteochondral autograft transplantation for isolated patellofemoral osteoarthritis. Knee, 2017, 24(6): 1498-1503.
23.	Baltzer AW, Ostapczuk MS, Terheiden HP, et al. Good short- to medium-term results after osteochondral autograft transplantation (OAT) in middle-aged patients with focal, non-traumatic osteochondral lesions of the knee. Orthop Traumatol Surg Res, 2016, 102(7): 879-884.
24.	Degen RM, Coleman NW, Chang B, et al. Outcomes following structural grafting of distal femoral osteochondral injuries in patients aged 40 years and older. J Knee Surg, 2016, 30(3): 244-251.

1. Curl WW, Krome J, Gordon ES, et al. Cartilage injuries: a review of 31,516 knee arthroscopies. Arthroscopy, 1997, 13(4): 456-460.
2. Hjelle K, Solheim E, Strand T, et al. Articular cartilage defects in 1,000 knee arthroscopies. Arthroscopy, 2002, 18(7): 730-734.
3. Shelbourne KD, Jari S, Gray T. Outcome of untreated traumatic articular cartilage defects of the knee: a natural history study. J Bone Joint Surg (Am), 2003, 85-A(Suppl 2): 8-16.
4. Varela-Eirin M, Loureiro J, Fonseca E, et al. Cartilage regeneration and ageing: Targeting cellular plasticity in osteoarthritis. Ageing Res Rev, 2018, 42: 56-71.
5. 黄志刚, 王耀, 马克. 低氧诱导因子1α基因在大鼠终板软骨细胞中的表达及意义研究. 中国修复重建外科杂志, 2017, 31(3): 103-108.
6. 桑伟林, 姜亚飞, 程飚, 等. 硬化蛋白在内翻畸形膝关节内外侧胫骨平台软骨下骨中的表达差异及其意义. 中国修复重建外科杂志, 2017, 31(3): 47-51.
7. Haien Z, Jiachang W, Qiang L, et al. Osteochondral autologous transplantation compared to microfracture for treating osteochondral defect: An updated meta-analysis of randomized controlled trials. J Knee Surg, 2017, 31(4): 341-347.
8. Krych AJ, Harnly HW, Rodeo SA, et al. Activity levels are higher after osteochondral autograft transfer mosaicplasty than after microfracture for articular cartilage defects of the knee: a retrospective comparative study. J Bone Joint Surg (Am), 2012, 94(11): 971-978.
9. Gudas R, Gudaité A, Mickevičius T, et al. Comparison of osteochondral autologous transplantation, microfracture, or debridement techniques in articular cartilage lesions associated with anterior cruciate ligament injury: a prospective study with a 3-year follow-up. Arthroscopy, 2013, 29(1): 89-97.
10. Shimozono Y, Hurley ET, Nguyen JT, et al. Allograft compared with autograft in osteochondral transplantation for the treatment of osteochondral lesions of the talus. J Bone Joint Surg (Am), 2018, 100(21): 1838-1844.
11. Sherman SL, Thyssen E, Nuelle CW. Osteochondral autologous transplantation. Clin Sports Med, 2017, 36(3): 489-500.
12. Haddo O, Mahroof S, Higgs D, et al. The use of chondrogide membrane in autologous chondrocyte implantation. Knee, 2004, 11(1): 51-55.
13. Gross AE. Repair of cartilage defects in the knee. J Knee Surg, 2002, 15(3): 167-169.
14. Robert H. Chondral repair of the knee joint using mosaicplasty. Orthop Traumatol Surg Res, 2011, 97(4): 418-429.
15. Matsusue Y, Yamamuro T, Hama H. Arthroscopic multiple osteochondral transplantation to the chondral defect in the knee associated with anterior cruciate ligament disruption. Arthroscopy, 1993, 9(3): 318-321.
16. Richter DL, Tanksley JA, Miller MD. Osteochondral autograft transplantation: A review of the surgical technique and outcomes. Sports Med Arthrosc Rev, 2016, 24(2): 74-78.
17. Tanaka Y, Mima H, Yonetani Y, et al. Histological evaluation of spontaneous osteonecrosis of the medial femoral condyle and short-term clinical results of osteochondral autografting: a case series. Knee, 2009, 16(2): 130-135.
18. Frisbie DD, Oxford JT, Southwood L, et al. Early events in cartilage repair after subchondral bone microfracture. Clin Orthop Relat Res, 2003, (407): 215-227.
19. Solheim E, Hegna J, Oyen J, et al. Osteochondral autografting (mosaicplasty) in articular cartilage defects in the knee: results at 5 to 9 years. Knee, 2010, 17(1): 84-87.
20. Solheim E, Hegna J, Strand T, et al. Randomized study of long-term (15-17 years) outcome after microfracture versus mosaicplasty in knee articular cartilage defects. Am J Sports Med, 2018, 46(4): 826-831.
21. Lynch TS, Patel RM, Benedick A, et al. Systematic review of autogenous osteochondral transplant outcomes. Arthroscopy, 2015, 31(4): 746-754.
22. Yabumoto H, Nakagawa Y, Mukai S, et al. Osteochondral autograft transplantation for isolated patellofemoral osteoarthritis. Knee, 2017, 24(6): 1498-1503.
23. Baltzer AW, Ostapczuk MS, Terheiden HP, et al. Good short- to medium-term results after osteochondral autograft transplantation (OAT) in middle-aged patients with focal, non-traumatic osteochondral lesions of the knee. Orthop Traumatol Surg Res, 2016, 102(7): 879-884.
24. Degen RM, Coleman NW, Chang B, et al. Outcomes following structural grafting of distal femoral osteochondral injuries in patients aged 40 years and older. J Knee Surg, 2016, 30(3): 244-251.

Chinese Journal of Reparative and Reconstructive Surgery

Comparison of arthroscopic osteochondral autologous transplantation for articular cartilage injury in young and middle-aged patients

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