Summary

Autologous osteochondral transplantation demonstrates effective long-term outcomes for symptomatic femoral cartilage lesions, with younger patients showing better functional results compared to those over 35 years of age.

Abstract

Introduction

Autologous osteochondral transplantation (OAT) is a viable option in osteochondral lesions and has shown promising outcomes in the short and medium term.

Purpose

Describe the functional outcomes in the medium and long term for patients treated with OATS in femoral lesions.

Methods

Retrospective study of patients who underwent knee surgery due to symptomatic femoral chondral lesions unresponsive to conservative treatment. We included patients up to 50 years with at least one high-grade lesion. Patients with infection, rheumatoid arthritis, and degenerative lesions were excluded. Functional scales (IKDC, Lysholm, and KOOS) were measured with an average follow-up of 5.6 years (3-10 years) and their correlation with other demographic variables. Statistical analysis was performed using t-student test, chi-square, and logistic regression.

Results

A total of 55 patients between 2013 and 2019 were analyzed. 72.7% were male. The mean age was 31.9 years (14-50), the mean follow-up was 67.2 (36-120) months, and the mean lesion size was 1.26 (0.5-4) cm2. 81.4% of patients required a single plug (the remainder received two plugs). The average functional results were as follows: IKDC 78.1 (34.4 - 100), Lysholm 83.7 (35 - 100), and KOOS 76.2 (38.8 - 100). The main predisposing factor for lower functional outcomes (IKDC <75) was the age at the time of surgery. The mean IKDC for patients over 35 years was 71.1 compared to 84.4 in younger individuals (p value <0.01).

Conclusion

Autologous osteochondral transplantation proved to be an effective treatment option for patients with symptomatic femoral cartilage lesions, with good functional outcomes in the long term. Older patients tend to have worse results compared to younger patients.