Functional outcomes after patellar autologous osteochondral transplantation

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2017-10, Vol.25 (10), p.3084-3091
• Main Authors: Astur, Diego Costa, Bernardes, Adilio, Castro, Saulo, Arliani, Gustavo Gonçalves, Kaleka, Camila Cohen, Astur, Nelson, Cohen, Moisés
• Format: Article
• Language: English
• Subjects: Adult; Athletic Injuries; Autografts; Biocompatibility; Cartilage, Articular - surgery; Female; Follow-Up Studies; Gait; Humans; Knee; Male; Medicine; Medicine & Public Health; Mobility; Muscle strength; Orthopedics; Outcome Assessment (Health Care); Pain; Patella - surgery; Patients; Prospective Studies; Range of Motion, Articular; Skin & tissue grafts; Surgery; Swelling; Transplantation; Transplantation, Autologous; Treatment Outcome; Trophic levels; Trophic status
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-016-4108-z

Purpose The aim of the present study was to assess clinical evaluation of patients who underwent autologous osteochondral transplantation of the patella. Methods This prospective study assessed outcomes of 20 patients who underwent patellar autologous osteochondral transplantation at four time-points: preoperatively, 3 days, 6 months, and 2 years after surgery. The following outcomes were assessed at each time-point: pain (VAS), gait, swelling, trophic status, muscle strength, patellar mobility, and range of motion. The Tegner scale was also applied for each time-point. Results All parameters improved, except for patellar mobility, which did not show any change. Pain score decreased from 7.1 (SD 2.3) to 2.4 (SD 2.6) at the 2-year assessment; limping decreased from 70 % before surgery to 15 % 2 years later; swelling scores decreased from an average of 1.8 (SD 0.8) 3 days after surgery to 0.5 (SD 0.7) at the 2-year assessment; muscle strength increased from 3.9 (SD 0.8) to 4.7 (SD 0.7) points at final follow-up; and the range of motion increased from 84 (SD 16.2) to 132 (SD 10.7) degrees 2 years later. Tegner score before surgery ranged from 0 to 5, and after 2 years, it ranged from 5 to 9. Conclusion Autologous osteochondral transplantation for the treatment of patellar chondral lesion was associated with significant improvement in pain, gait, swelling, and range of motion 2 years after surgery, achieving scores similar to uninjured knees. Most of them were able to return to sports activity after 6 months (recreational level) and 2 years (competitive level). Level of evidence IV.