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Osteochondral autograft of patella. Experience up to 10 years of follow-up

INTRODUCTION: The optimal treatment of an osteochondral patellar lesion remains controversial. Autologous osteochondral transplantation shows promising outcomes, although there is scarce evidence. OBJECTIVE: Present a 10-year follow-up experience and outcomes of patients with a full-thickness defect...

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Detalles Bibliográficos
Autores principales: Poblete, David Figueroa, Valdés, Jaime Esteban Espinoza, Sotomayor, Juan José, O´Conell, Luis
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6311570/
http://dx.doi.org/10.1177/2325967118S00206
Descripción
Sumario:INTRODUCTION: The optimal treatment of an osteochondral patellar lesion remains controversial. Autologous osteochondral transplantation shows promising outcomes, although there is scarce evidence. OBJECTIVE: Present a 10-year follow-up experience and outcomes of patients with a full-thickness defect of the patella at our institution. METHODS: Retrospective analysis of all the patients treated with autologous osteochondral transplantation between 2007-2018 for a patellar osteochondral lesion (ICRS IV). We analyzed the WOMAC score and demographic characteristics with IBM SPSS (IBM Corp. Released 2017. IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp). RESULTS: A total of 14 patients (age range 15-49 years) were included. The right knee, medial facet, and the medial patellofemoral ligament (69%) were the anatomical sections and associated injuries most frequently encountered. The mean lesion area was of 1.32 cm2, with 55% requiring 2 autologous osteochondral transplantations (size range 8-10 mm2). The mean WOMAC score was 97% (91% Pain, 87% Stiffness, 95% Physical function), with a tendency of an inverse relation with age (p=0.227). CONCLUSION: Full-thickness defects of patellar cartilage are seen frequently in young patients. These lesions affect their quality of life, sports activity, and physical functionality. However, our outcomes at medium-term follow-up (Mean WOMAC 97), despite it is a small cohort, are promising. Long-term follow-up studies on this topic are encouraged to suggest an optimal treatment based on high-quality evidence.