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01-08-2010 | Original Paper

Treatment of osteochondritis dissecans of the femoral condyle with autologous bone grafts and matrix-supported autologous chondrocytes

Authors: Joern Steinhagen, Juergen Bruns, Georg Deuretzbacher, Wolfgang Ruether, Martin Fuerst, Oliver Niggemeyer

Published in: International Orthopaedics | Issue 6/2010

Abstract

The objective of this study was to determine the clinical outcome of combined bone grafting and matrix-supported autologous chondrocyte transplantation in patients with osteochondritis dissecans of the knee. Between January 2003 and March 2005, 21 patients (mean age 29.33 years) with symptomatic osteochondritis dissecans (OCD) of the medial or lateral condyle (grade III or IV) of the knee underwent reconstruction of the joint surface by autologous bone grafts and matrix-supported autologous chondrocyte transplantation. Patients were followed up at three, six, 12 and 36 months to determine outcomes by clinical evaluation based on Lysholm score, IKDC and ICRS score. Clinical results showed a significant improvement of Lysholm-score and IKDC score. With respect to clinical assessment, 18 of 21 patients showed good or excellent results 36 months postoperatively. Our study suggests that treatment of OCD with autologous bone grafts and matrix-supported autologous chondrocytes is a possible alternative to osteochondral cylinder transfer or conventional ACT.

Clanton TO, DeLee JC (1982) Osteochondritis dissecans. History, pathophysiology and current treatment concepts. Clin Orthop Relat Res 167:50–64PubMed

Aichroth P (1971) Osteochondritis dissecans of the knee. A clinical survey. J Bone Jt Surg Br 53(3):440–447

Glancy GL (1999) Juvenile osteochondritis dissecans. Am J Knee Surg 12(2):120–124PubMed

Cahill BR, Phillips MR, Navarro R (1989) The results of conservative management of juvenile osteochondritis dissecans using joint scintigraphy. A prospective study. Am J Sports Med 17 (5):601-605, discussion 5–6CrossRefPubMed

Nakagawa T, Kurosawa H, Ikeda H et al (2005) Internal fixation for osteochondritis dissecans of the knee. Knee Surg Sports Traumatol Arthrosc 13(4):317–322CrossRefPubMed

Steadman JR, Miller BS, Karas SG et al (2003) The microfracture technique in the treatment of full-thickness chondral lesions of the knee in National Football League players. J Knee Surg 16(2):83–86PubMed

Bouwmeester PS, Kuijer R, Homminga GN et al (2002) A retrospective analysis of two independent prospective cartilage repair studies: autogenous perichondrial grafting versus subchondral drilling 10 years post-surgery. J Orthop Res 20(2):267–273CrossRefPubMed

Bentley G, Biant LC, Carrington RW et al (2003) A prospective, randomised comparison of autologous chondrocyte implantation versus mosaicplasty for osteochondral defects in the knee. J Bone Jt Surg Br 85(2):223–230CrossRef

Peterson L, Minas T, Brittberg M et al (2000) Two- to 9-year outcome after autologous chondrocyte transplantation of the knee. Clin Orthop Relat Res 374:212–234CrossRefPubMed

10.

International Cartilage Repair Society (2008) ICRS evaluation. Available at: www.cartilage.org Site accessed 10 July 2009

11.

Lysholm J, Gillquist J (1982) Evaluation of knee ligament surgery results with special emphasis on use of a scoring scale. Am J Sports Med 10(3):150–154CrossRefPubMed

12.

Green WT, Banks HH (1953) Osteochondritis dissecans in children. J Bone Jt Surg Am 35A(1):26–47

13.

Koch S, Kampen WU, Laprell H (1997) Cartilage and bone morphology in osteochondritis dissecans. Knee Surg Sports Traumatol Arthrosc 5(1):42–45CrossRefPubMed

14.

Michael JW, Wurth A, Eysel P, Konig DP (2008) Long-term results after operative treatment of osteochondritis dissecans of the knee joint – 30 year results. Int Orthop 32(2):217–221CrossRefPubMed

15.

Anderson AF, Pagnani MJ (1997) Osteochondritis dissecans of the femoral condyles. Long-term results of excision of the fragment. Am J Sports Med 25(6):830–834CrossRefPubMed

16.

Wright RW, McLean M, Matava MJ et al (2004) Osteochondritis dissecans of the knee: long-term results of excision of the fragment. Clin Orthop Relat Res 424:239–243CrossRefPubMed

17.

Aglietti P, Ciardullo A, Giron F et al (2001) Results of arthroscopic excision of the fragment in the treatment of osteochondritis dissecans of the knee. Arthroscopy 17(7):741–746CrossRefPubMed

18.

Murray JR, Chitnavis J, Dixon P et al (2007) Osteochondritis dissecans of the knee; long-term clinical outcome following arthroscopic debridement. Knee 14(2):94–98CrossRefPubMed

19.

Twyman RS, Desai K, Aichroth PM (1991) Osteochondritis dissecans of the knee. A long-term study. J Bone Jt Surg Br 73(3):461–464

20.

Bouwmeester SJ, Beckers JM, Kuijer R et al (1997) Long-term results of rib perichondrial grafts for repair of cartilage defects in the human knee. Int Orthop 21(5):313–317CrossRefPubMed

21.

Laprell H, Petersen W (2001) Autologous osteochondral transplantation using the diamond bone-cutting system (DBCS): 6–12 years' follow-up of 35 patients with osteochondral defects at the knee joint. Arch Orthop Trauma Surg 121(5):248–253CrossRefPubMed

22.

Horas U, Pelinkovic D, Herr G et al (2003) Autologous chondrocyte implantation and osteochondral cylinder transplantation in cartilage repair of the knee joint. A prospective, comparative trial. J Bone Jt Surg Am 85-A (2):185-192

23.

Andereya S, Maus U, Gavenis K et al (2006) First clinical experiences with a novel 3D-collagen gel (CaReS) for the treatment of focal cartilage defects in the knee. Z Orthop Ihre Grenzgeb 144(3):272–280CrossRefPubMed

24.

Ochs BG, Muller-Horvat C, Rolauffs B et al (2007) Treatment of osteochondritis dissecans of the knee: one-step procedure with bone grafting and matrix-supported autologous chondrocyte transplantation. Z Orthop Unfall 145(2):146–151CrossRefPubMed

25.

Maus U, Schneider U, Gravius S et al (2008) Clinical results after three years use of matrix-associated ACT for the treatment of osteochondral defects of the knee. Z Orthop Unfall 146(1):31–37CrossRefPubMed

26.

Krishnan SP, Skinner JA, Carrington RW et al (2006) Collagen-covered autologous chondrocyte implantation for osteochondritis dissecans of the knee: two- to seven-year results. J Bone Jt Surg Br 88(2):203–205CrossRef

Title: Treatment of osteochondritis dissecans of the femoral condyle with autologous bone grafts and matrix-supported autologous chondrocytes
Authors: Joern Steinhagen
Juergen Bruns
Georg Deuretzbacher
Wolfgang Ruether
Martin Fuerst
Oliver Niggemeyer
Publication date: 01-08-2010
Publisher: Springer-Verlag
Published in: International Orthopaedics / Issue 6/2010
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-009-0841-y

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Treatment of osteochondritis dissecans of the femoral condyle with autologous bone grafts and matrix-supported autologous chondrocytes

Abstract

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