Autogenous Osteochondral Grafting for Treatment of Knee Osteochondritis Dissecans: A Case Series Study

BackgroundAlthough some surgical techniques have been described for the operative treatment of unstableOsteochondritis dissecans (OCD) of the knee, outcomes are variable and are not satisfying totally. The aim of thepresent study is to evaluate the outcomes of autogenous osteochondral grafting for OCD of the knee.MethodsIn a case series study, from June 2014 to July 2015, 16 patients with stage II-IV OCD (International CartilageRepair Society (ICRS)) of the femoral condyle were investigated. Surgical intervention considered in cases of stage III(4 cases) and IV (2 cases) and in stage II (10 cases) ones that were nonresponsive to conservative treatment. At theinitial and final visits, the IKDC, Lysholm score and Tegner activity scale were evaluated.ResultsThe mean preoperative IKDC score (53.4) increased significantly following surgery (84.3) (P<0.001).Based on the IKDC grading system, before the operation, the knee status was graded as nearly normal, abnormal,and severely abnormal in 4, 10, and 2 patients, respectively. At final post-surgical follow up, 15 normal and 1abnormal knee were documented (P<0.001). The mean Lysholm score increased from 44.3 per operatively to 86.3(P<0.001).Tegner activity score improved from 2.8±1 pre operatively to 5.6 ±2 (P<0.001).ConclusionSurgical treatment of unstable OCD using autogenous osteochondral graft shows successful outcomes.In addition to reliable fixation, it can enhance healing and convert an uncontained lesion to contained one appropriatefor autogenous osteochondral grafting with healthy cartilage.Level of evidence: IV