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Orthop Traumatol Surg Res ; 101(3): 313-7, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25817908

RESUMO

INTRODUCTION: Autogenous osteochondral mosaicplasty is the most common cartilage restoration technique in standard clinical practice. The purpose of this study was to evaluate the return to sports 9 years after mosaicplasty of the femoral condyles. HYPOTHESIS: The long-term results of an osteochondral autograft show that patients can regain their pre-injury activity level. MATERIAL AND METHODS: This study is based on a series of 25 patients with a mean age of 28.9 years (range, 16-44 years) who had stage 3 or 4 chondral lesions of the femoral condyles (according to the ICRS or ICRS-OCD scores). The origin of the lesion was osteochondritis dissecans (13 knees), osteochondral fracture sequelae (ten knees), or aseptic osteonecrosis (two knees). The average size of the lesion was 2.11 ± 0.9 cm(2). Ten patients (40%) had an associated procedure during the osteochondral autograft. The patients were assessed clinically (IKDC and Lysholm-Tegner scores) and radiographically by a reviewer independent of the team of operators. RESULTS: All patients were re-examined at a mean follow-up of 9 years (range, 6-15 years), with 84% satisfied or very satisfied with the procedure. The average IKDC was 74.5 ± 18.5 points. The average Lysholm score was 87.3 ± 11.6 points. The average Tegner score ranged from 6.35 ± 1.53 points prior to surgery to 5.60 ± 1.64 points after surgery (P = 0.001). The average loss was 0.64 points for patients whose presurgery Tegner score was greater than or equal to 7 (P = 0.019) and 0.3 points if lower than 7. The radiologic evaluation of 21 patients showed complete osteointegration of the grafts in 90% of cases. CONCLUSION: The results of the femoral condyle mosaic autografts are satisfactory, a mean of 9 years after surgery. The most active patients lowered their activity level while the more sedentary did not have to adapt their lifestyle.


Assuntos
Transplante Ósseo , Cartilagem/transplante , Fêmur/cirurgia , Volta ao Esporte , Adolescente , Adulto , Cartilagem Articular/diagnóstico por imagem , Cartilagem Articular/lesões , Cartilagem Articular/cirurgia , Epífises/diagnóstico por imagem , Epífises/cirurgia , Feminino , Fêmur/diagnóstico por imagem , Seguimentos , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Escore de Lysholm para Joelho , Masculino , Osteocondrite Dissecante/cirurgia , Osteonecrose/cirurgia , Radiografia , Transplante Autólogo , Resultado do Tratamento , Adulto Jovem
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