Use of Autologous Minced Cartilage for the Treatment Of Chondral Defects in Femoral Condyles of Physical Workers


Javier Antonio Ruiz Díaz, MD
SPAIN

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Use of Autologous Minced Cartilage for the Treatment Of Chondral Defects in Femoral Condyles of Physical Workers

Javier Antonio Ruiz Díaz, MD, SPAIN Rubén Alvarez Canal, MD, SPAIN Celestino Guerra García, MD, PhD, SPAIN Franciso J. Álvarez García, MD, SPAIN Javier Higuera, MD, SPAIN Amaury González Llorca, MD, SPAIN Gabriel López Graña, MD, SPAIN

Ibermutua Asturiana, Oviedo - Gijón, Asturias, SPAIN

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Treatment / Technique

Biologics Autograft Arthroscopy Transplantation

Anatomic Structure

Cartilage

Diagnosis / Condition

Arthritis Osteoarthritis

Sports Medicine

Basic Science Outcome Studies

Cartilage

Osteochondritis Cartilage Treatment

Summary: Our prospective study using autologous minced cartilage to treat chondral lesions in femoral condyles of physical workers shows good short-term results

Introduction

Chondral injuries are debilitating lesions that frequently affect physical workers. Autologous minced cartilage is a newer technique used to treat symptomatic cartilage defects. We aim to evaluate the clinical utility of autologous minced cartilage for treating cartilage defects in the femoral condyles of physical workers.

Materials And Methods

Fifteen physical laborers (10 men, 5 women) with a mean age of 40.4 years (24-56) with a single grade III (11 cases) or IV (4 cases) chondral lesion in the femoral condyle’s weight-bearing area (12 medial, 3 lateral) were treated by autologous minced cartilage transplantation and prospectively followed for a period of at least eighteen months (18-30 months). The lesion was confirmed under arthroscopic vision and debrided. Using an arthroscopic shaver connected to a filter collector, donor cartilage was taken from the edges of the lesion and, if insufficient, from the intercondylar notch or the non-weight-bearing area of the femoral condyle. After this, it was augmented with autologous plasma, implanted in the defect, and fixed with autologous thrombin. Concomitant lesions were also treated. Pre and postoperative functional assessment was performed using the Oxford Knee Score (OKS) and Knee Society Score (KSS) questionnaires.

Results

All patients had one or more concomitant injuries: 11 meniscal injuries (9 medial, 2 lateral) and 8 anterior cruciate ligament injuries. The mean defect area was 3.48cm² (1.43cm²-5.72cm²). OKS results went from 15.93 (range 11-22) to 40.6 (range 31-48) and KSS results went from 43.8 (range 20-58) to 86.46 (range 67-100). All patients were discharged and returned to work at an average of 18.33 weeks (range 7-30 weeks).

Conclusions

Treating single chondral lesions in femoral condyles by implantation of autologous minced cartilage is an option with good short-term functional and occupational results in physical workers.

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