The Morbidity Associated With Osteochondral Harvest From Asymptomatic Knees for the Treatment of Osteochondral Lesions of the Talus

• Published in: The American journal of sports medicine 2007-01, Vol.35 (1), p.80-85
• Main Authors: Reddy, Sudheer, Pedowitz, David I., Parekh, Selene G., Sennett, Brian J., Okereke, Enyi
• Format: Article
• Language: English
• Subjects: Adult; Ankle; Ankle injuries; Anklebone; Arthroscopy; Biological and medical sciences; Care and treatment; Epidemiology; Female; Femur - transplantation; Fundamental and applied biological sciences. Psychology; General aspects; Humans; Injuries; Knee; Knee Joint - surgery; Male; Medical sciences; Middle Aged; Morbidity; Orthopedics; Osteochondritis; Osteochondritis - surgery; Osteochondrosis; Public health. Hygiene; Public health. Hygiene-occupational medicine; Retrospective Studies; Risk factors; Skin & tissue grafts; Sport (general aspects); Sports injuries; Sports medicine; Talus (Anklebone); Talus - pathology; Talus - surgery; Transplantation; Transplantation of organs, tissues, etc; Transplantation, Autologous; Traumas. Diseases due to physical agents; Treatment Outcome; Vertebrates: body movement. Posture. Locomotion. Flight. Swimming. Physical exercise. Rest. Sports
• ISSN: 0363-5465; 1552-3365
• DOI: 10.1177/0363546506290986

Background: Mosaic autogenous osteochondral transplantation has been used to treat large osteochondral defects. Hypothesis: There is potential, previously unrecognized donor-site morbidity associated with osteochondral harvest from asymptomatic knees for the treatment of talar osteochondral defect lesions. Study Design: Case series; Level of evidence, 4. Methods: Fifteen patients underwent mosaic osteochondral transplantation to treat a talar osteochondral defect lesion, with 11 patients available for follow-up. A Lysholm knee score was used to assess donor-site morbidity at a mean follow-up of 47 months (range, 7–77 months). Mean age was 29 years (range, 21–44 years). A single surgical team performed the mosaicplasties. Significance was determined using the Student t test. Results: All patients had asymptomatic knees preoperatively. Mean postoperative Lysholm score was 81 (range, 49–100). By Lysholm criteria, 5 rated as excellent, 2 as good, and 4 as poor. No significant difference was detected in terms of the harvest method or the number of grafts obtained from those having an excellent rating versus those having a good/poor rating. Patients rated as good/poor cited knee instability in daily activities as the most common problem. One had knee pain and patellar instability after osteochondral harvest by lateral arthrotomy that required a subsequent lateral retinacular release and tibial tubercle osteotomy. Conclusion: This study demonstrates that donor-site morbidity after osteochondral harvest can be significant. In this population, those who experienced a decline in knee function had problems performing activities of daily living. When performing these procedures, the authors recommend that surgeons consider these risks and discuss them with their patients. Keywords: osteochondral talus mosaicplasty morbidity