Skip to main content
SpringerLink
Log in

Osteochondral autograft transplantation for juvenile osteochondritis dissecans of the knee: a series of twelve cases

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to evaluate the clinical outcomes of osteochondral autograft transplantation (OAT) for juvenile osteochondritis dissecans (JOCD) lesions of the knee, especially time to return to sports.

Methods

Twelve knee JOCD lesions with OCD grade 3 and 4 categorised by magnetic resonance imaging (MRI) were treated with OAT. Nine male and two female skeletally immature patients averaging 13.7 years old were included. The OCD lesions were assessed arthroscopically and then fixed in situ using multiple osteochondral plugs harvested under fluoroscopy from the distal femoral condyle without damaging the physis. International Cartilage Repair Society (ICRS) score and Lysholm score were assessed pre- and postoperatively.

Results

After a mean follow-up of 26.2 ± 15.1 months, the International Knee Documentation Committee (IKDC) subjective score significantly improved (p < 0.01). According to the IKDC score, objective assessment showed that ten of 12 (83 %) had excellent results (score: A) after OAT and significantly improved (p < 0.01). Based on ICRS criteria, results were satisfactory in all patients. No patients experienced complications at the graft harvest site. All patients returned to their previous level of athletic activity at an average of 5.7 months after the surgery.

Conclusions

OAT for JOCD of the knee provided satisfactory results in all patients at a mean follow-up of 26.2 months.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Hughston JC, Hergenroeder PT, Courtenay BG (1984) Osteochondritis dissecans of the femoral condyles. J Bone Joint Surg Am 66:1340–1348

    PubMed  CAS  Google Scholar 

  2. Robertson W, Kelly BT, Green DW (2003) Osteochondritis dissecans of the knee in children. Curr Opin Pediatr 15:38–44

    Article  PubMed  Google Scholar 

  3. Linden B (1977) Osteochondritis dissecans of the femoral condyles: a long-term follow-up study. J Bone Joint Surg Am 59:769–776

    PubMed  CAS  Google Scholar 

  4. Pappas AM (1981) Osteochondrosis dissecans. Clin Orthop Relat Res 158:59–69

    PubMed  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  6. Williams JS Jr, Bush-Joseph CA, Bach BR Jr (1998) Osteochondritis dissecans of the knee. Am J Knee Surg 11:221–232

    PubMed  Google Scholar 

  7. Yoshida S, Ikata T, Takai H, Kashiwaguchi S, Katoh S, Takeda Y (1998) Osteochondritis dissecans of the femoral condyle in the growth stage. Clin Orthop Relat Res 346:162–170

    Article  PubMed  Google Scholar 

  8. Bonhdorf K (1998) Osteochondritis (osteochondrosis) dissecans: a review and new MRI classification. Eur Radiol 8:103–112

    Article  Google Scholar 

  9. Dipaola J, Nelson DW, Colville M (1991) Characterizing osteochondral lesions by magnetic resonance imaging. Arthroscopy 7:101–104

    Article  PubMed  CAS  Google Scholar 

  10. Garrett JC (1991) Osteochondritis dissecans. Clin Sports Med 10:569–593

    PubMed  CAS  Google Scholar 

  11. Hayan R, Phillipe G, Ludovic S, Claude K, Jean-Michel C (2009) Juvenile osteochondritis of femoral condyles: treatment with transchondral drilling. Analysis of 40 cases. J Child Orthop 4(1):39–44

    Article  PubMed  Google Scholar 

  12. Johnson LL, Uitvlugt G, Austin MD, Detrisac DA, Johnson C (1990) Osteochondritis dissecans of the knee: arthroscopic compression screw fixation. Arthroscopy 6:179–189

    Article  PubMed  CAS  Google Scholar 

  13. Kocher MS, Czarnecki JJ, Andersen JS, Micheli LJ (2007) Internal fixation of juvenile osteochondritis dissecans lesions of the knee. Am J Sports Med 35:712–718

    Article  PubMed  Google Scholar 

  14. Micheli LJ, Moseley JB, Anderson AF et al (2006) Articular cartilage defects of the distal femur in children and adolescents: treatment with autologous chondrocyte implantation. J Pediatr Orthop 26:455–460

    Article  PubMed  Google Scholar 

  15. Steinhagen J, Bruns J, Deuretzbacher G, Ruether W, Fuerst M, Niggemeyer O (2010) Treatment of osteochondritis dissecans of the femoral condyle with autologous bone grafts and matrix-supported autologous chondrocytes. Int Orthop 34:819–825

    Article  PubMed  Google Scholar 

  16. Berlet GC, Mascia A, Miniaci A (1999) Treatment of unstable osteochondritis dissecans lesions of the knee using autogenous osteochondral grafts (mosaicplasty). Arthroscopy 15:312–316

    Article  PubMed  CAS  Google Scholar 

  17. Miura K, Ishibashi Y, Tsuda E, Sato H, Toh S (2007) Results of arthroscopic fixation of osteochondritis dissecans lesion of the knee with cylindrical autogenous osteochondral plugs. Am J Sports Med 35:216–222

    Article  PubMed  Google Scholar 

  18. Nelson DW, DiPaola J, Colville M, Schmidgall J (1990) Osteochondritis dissecans of the talus and knee: prospective comparison of MR and arthroscopic classifications. J Comput Assist Tomogr 14:804–808

    Article  PubMed  CAS  Google Scholar 

  19. ICRS Cartilage Injury Evaluation Package. Available via http://www.cartilage.org/_files/contentmanagement/ICRS_evaluation.pdf

  20. Hangody L, Füles P (2003) Autologous osteochondral mosaicplasty for the treatment of full-thickness defects of weight-bearing joints: ten years of experimental and clinical experience. J Bone Joint Surg Am 85-A(Suppl 2):25–32

    PubMed  Google Scholar 

  21. Hangody L, Kish G, Kárpáti Z, Udvarhelyi I, Szigeti I, Bély M (1998) Mosaicplasty for the treatment of articular cartilage defects: application in clinical practice. Orthopedics 21:751–756

    PubMed  CAS  Google Scholar 

  22. Matsusue Y, Yamamuro T, Hama H (1993) Arthroscopic multiple osteochondral transplantation to the chondral defect in the knee associated with anterior cruciate ligament disruption. Arthroscopy 9:318–321

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  24. De Smet AA, Ilahi OA, Graf BK (1997) Untreated osteochondritis dissecans of the femoral condyles: prediction of patient outcome using radiographic and MR findings. Skeletal Radiol 26:463–467

    Article  PubMed  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  26. Sales de Gauzy J, Mansat C, Darodes PH, Cahuzac JP (1999) Natural course of osteochondritis dissecans in children. J Pediatr Orthop B 8:26–28

    Article  PubMed  CAS  Google Scholar 

  27. Brückl R, Rosemeyer B, Thiermann G (1982) Results of operative treatment of osteochondrosis dissecans of the knee joint in juveniles. Z Orthop Ihre Grenzgeb 120:717–724

    Article  PubMed  Google Scholar 

  28. Gudas R, Kalesinskas RJ, Kimtys V, Stankevicius E, Toliusis V, Bernotavicius G, Smailys A (2005) A prospective randomized clinical study of mosaic osteochondral autologous transplantation versus microfracture for the treatment of osteochondral defects in the knee joint in young athletes. Arthroscopy 21:1066–1075

    Article  PubMed  Google Scholar 

  29. Peterson L, Minas T, Brittberg M, Lindahl A (2003) Treatment of osteochondritis dissecans of the knee with autologous chondrocyte transplantation: results at two to ten years. J Bone Joint Surg Am 85-A(Suppl 2):17–24

    PubMed  Google Scholar 

Download references

Acknowledgment

The authors thank Ms. Janina Tubby for help in preparing the manuscript.

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho Chuo-ku, Kobe, 650-0017, Hyogo, Japan

    Ken Sasaki, Tomoyuki Matsumoto, Takehiko Matsushita, Seiji Kubo, Kazunari Ishida, Katsumasa Tei, Toshihiro Akisue, Masahiro Kurosaka & Ryosuke Kuroda

Authors
  1. Ken Sasaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tomoyuki Matsumoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Takehiko Matsushita
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Seiji Kubo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kazunari Ishida
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Katsumasa Tei
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Toshihiro Akisue
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Masahiro Kurosaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Ryosuke Kuroda
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ryosuke Kuroda.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sasaki, K., Matsumoto, T., Matsushita, T. et al. Osteochondral autograft transplantation for juvenile osteochondritis dissecans of the knee: a series of twelve cases. International Orthopaedics (SICOT) 36, 2243–2248 (2012). https://doi.org/10.1007/s00264-012-1648-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-012-1648-9

Keywords

Search

Navigation