Arthroscopic versus Open Osteochondral Autograft Transplantation (Mosaicplasty) for Cartilage Damage of the Knee: A Systematic Review

J Knee Surg DOI: 10.1055/s-0039-1692999Osteochondral autograft transplantation (OAT) is a surgical option for repairing cartilage damage in knees, and can be performed using open or arthroscopic procedures. The aim of this review was to report clinical outcomes, postoperative complications, defect location, and defect size between open and arthroscopic OATs. Three electronic databases (EMBASE, PUBMED, and MEDLINE) were searched for relevant articles. In regard to eligibility criteria, knee articular damage cases solely treated with OAT were included and cases concomitant with ligament reconstruction, limb realignment, and meniscus repair were excluded. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and descriptive statistics are presented. A total of 24 studies were included with a total sample of 1,139 patients (532 in open OAT vs. 607 in arthroscopic OAT). Defect size in open OAT was three times larger than that of arthroscopic OAT (2.96 ± 0.76 vs. 0.97 ± 0.48 cm2). In terms of defect location, the medial femoral condyle (MFC) was the most common (75.4%), followed by the lateral femoral condyle (LFC; 12.1%), patella (6.7%), and trochlea (5.7%). All of these defect locations were treated with open OAT, whereas arthroscopic OAT treatments were restricted to the MFC and LFC. The clinical outcomes were overall favorable with the modified Hospital for Special Su...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research

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ConclusionsPost-meniscectomy pain syndrome and post-meniscectomy knee OA are common findings after meniscus resection. Short-term pain relief is provided by non-surgical management, mid-term pain relief by meniscus scaffolds, and long-term relief by MAT, though each has differing indications. In later stages, osteotomies and joint replacements are indicated.Level of evidenceIV.
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
Publication date: Available online 25 February 2019Source: Arthroscopy TechniquesAuthor(s): James Gwosdz, Alexander Rosinski, Moyukh Chakrabarti, Brittany M. Woodall, Nicholas Elena, Patrick J. McGahan, James L. ChenAbstractOsteochondritis dissecans (OCD) has been recognized for over 100 years yet still poses treatment challenges owing to both the avascular nature of articular cartilage and the inability to generate hyaline cartilage. The knee is most commonly involved, and without repair, patients have chronic knee pain, loose bodies, and early-onset osteoarthritis. There are a number of surgical techniques for repai...
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
ConclusionsOsteochondral allograft transplantation appears highly cost-effective though the cost per quality adjusted life year varies according to the widely varying costs of allografts. Based on one small study, revision OCA also appears very cost-effective, but more evidence is needed.Level of evidenceII.
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
Patients undergoing meniscal allograft transplantation show improvement at 10  years and even 15 years of follow-up. However, it is unclear what factors influence the results, including but not limited to bone plug versus all-suture repair, fresh versus cryopreserved grafts, proper sizing, and rehabilitation.
Source: Arthroscopy - Journal of Arthroscopic and Related Surgery - Category: Surgery Authors: Tags: Editorial Commentary Source Type: research
ConclusionOver ten different techniques are available for cartilage repair in the hip, and most of them have good short- to medium-term outcomes. However, there are no robust comparative studies to assess superiority of one technique over another, and further research is required in this arena.
Source: International Orthopaedics - Category: Orthopaedics Source Type: research
AbstractPurpose of ReviewWith an increasing rate of adolescent elbow injuries, especially in throwing athletes, the purpose of this review is to investigate the current literature regarding the diagnosis, treatment, and non-operative and operative outcomes of medial epicondyle fractures, ulnar collateral ligament repair, osteochondritis dissecans of the elbow, and olecranon stress fractures.Recent FindingsAcceptable outcomes with both non-operative and operative treatments of medial epicondyle fractures have been reported, with surgical indications continuing to evolve. Unstable osteochondritis dissecans lesions, especiall...
Source: Current Reviews in Musculoskeletal Medicine - Category: Orthopaedics Source Type: research
Articular cartilage injury and degeneration is a frequent occurrence in synovial joints. Treatment of these articular cartilage lesions are a challenge because this tissue is incapable of quality repair and/or regeneration to its native state. Nonoperative treatments endeavor to control symptoms, and include anti-inflammatory medication, viscosupplementation, bracing, orthotics, and activity modification. Techniques to stimulate the intrinsic repair (fibrocartilage) process include drilling, abrasion, and microfracture of the subchondral bone. Currently, the clinical biologic approaches to treat cartilage defects include a...
Source: Sports Medicine and Arthroscopy Review - Category: Sports Medicine Tags: Review Articles Source Type: research
Publication date: Available online 28 August 2017 Source:Arthroscopy Techniques Author(s): Kevin C. Wang, Brian R. Waterman, Eric J. Cotter, Rachel M. Frank, Brian J. Cole Isolated, full-thickness articular cartilage lesions of the glenohumeral joint can cause pain, mechanical symptoms, and impaired function. Reports on operative management of these injuries with arthroscopic techniques, such as marrow stimulation, have shown improvement in patient symptoms. In cases where the subchondral bone is involved, osteochondral allograft (OCA) transplantation has shown positive results for contained, focal cartilage defects. The ...
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
This article presents a technique for LMAT using bone plugs and standard arthroscopic portals.
Source: Arthroscopy Techniques - Category: Surgery Source Type: research
Conclusion A combination of retrograde osteochondral autograft transplantation and arthroscopic centralisation can be a good option to treat the osteochondral lesion of the tibial plateau caused by extrusion of the meniscus.
Source: Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology - Category: Sports Medicine Source Type: research
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