Osteochondral Autologous Transplantation for Treating Patellar High-Grade Chondral Defects: A Systematic Review
Journal
Orthopaedic Journal of Sports Medicine
ISSN
2325-9671
2325-9671
Date Issued
2019
Author(s)
Rodrigo Donoso
DAVID HUMBERTO FIGUEROA POBLETE
Jaime Espinoza
Claudio Yañez
Jamil Saavedra
Type
Resource Types::text::journal::journal article
URL Institutional Repository
Abstract
<jats:sec><jats:title>Background:</jats:title><jats:p>Patellar cartilage defects account for 34.6% of defects found during routine arthroscopy. These defects pose a challenge in orthopaedic surgery because they have been associated with worse outcomes after surgical repair compared with other chondral lesions within the knee.</jats:p></jats:sec><jats:sec><jats:title>Purpose:</jats:title><jats:p>To systematically review the literature for evidence on results of osteochondral autologous transplantation (OAT) for the management of isolated patellar cartilage high-grade defects (International Cartilage Repair Society [ICRS] grade 3-4).</jats:p></jats:sec><jats:sec><jats:title>Study Design:</jats:title><jats:p>Systematic review; Level of evidence, 4.</jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p>A systematic review of the literature was performed to find studies that addressed outcomes regarding OAT to treat patellar high-grade cartilage defects (ICRS grade 3-4). Studies addressing patient-reported outcomes, return to sports, or magnetic resonance imaging (MRI) at follow-up after isolated OAT procedures for patellar cartilage defects were included.</jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p>A total of 5 studies were included in this review. We were not able to perform a meta-analysis as no studies had available data. A total of 102 patients who received an isolated OAT for a patellar chondral defect were included in these 5 studies. All patients showed significant improvement at final follow-up based on the following patient-reported outcome scores: Lysholm, International Knee Documentation Committee, Kujala, Tegner, and 36-Item Short Form Health Survey. We found that 4 studies used MRI during the first postoperative year to assess osteochondral plug integration and positioning. The results demonstrated that most plugs were integrated and correctly positioned when evaluated at follow-up, conducted on average after 12 months. Whether patients were able to return to sports was queried in 2 of the included studies, revealing that patients could return to their previous level in most cases (Tegner score, 5-9 at 2 years after surgery).</jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p>Results indicate that OAT is a safe and reliable technique to treat patellar high-grade osteochondral defects, allowing for significant improvement in patient-reported outcomes and return to sports.</jats:p></jats:sec>
Subjects
patella
;
autologous
;
transplantation
;
osteochondral
;
chondral
;
cartilage
;
adult
;
autotransplantation
;
cartilage
;
documentation
;
female
;
follow up
;
human
;
knee
;
male
;
meta analysis
;
nuclear magnetic resonance imaging
;
outcome assessment
;
patella
;
patient-reported outcome
;
return to sport
;
review
;
short form 36
;
systematic review
;
tegner activity score