2023 ISAKOS Biennial Congress ePoster
Long-Term Clinical And Magnetic Resonance Imaging Results After Retropatellar Autologous Osteochondral Transplantation In Patellofemoral Stable and Unstable Patients
Alexander Otto, MD, Neufahrn, Bavaria GERMANY
Julian Mehl, MD, Munich, Bavaria GERMANY
Andreas Schmitt, MD, Munich, Bavaria GERMANY
Yannick Ehmann, MD, Munich, Deutschland GERMANY
Sebastian Siebenlist, MD, MHBA, Prof., Munich, Bavaria GERMANY
Andreas B. Imhoff, MD, Prof. Emeritus, Sauerlach / Munich, Bavaria GERMANY
Department of Sports Orthopaedics, Technical University of Munich, Munich, Bavaria, GERMANY
FDA Status Cleared
Summary
Autologous osteochondral transplantation for retropatellar defects yields good clinical and MRI longterm results in patellofemoral stable and unstable patients.
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Abstract
Purpose
The treatment of patellar chondral lesions represents a challenge to orthopaedic surgeons. Multiple surgical techniques for the treatment of patellar chondral lesions have emerged, including microfracture, autologous chondrocyte implantation, and osteochondral (auto-)graft transplantation. The purpose of this study was to assess clinical and magnetic resonance imaging (MRI) results after retropatellar autologous osteochondral transplantation in patellofemoral stable and unstable patients.
Methods
Patients that underwent autologous osteochondral transplantation for patellar chondral lesions between January 2007 and December 2016 were assessed in this single-centre retrospective study. Patients without patellofemoral instability (POAT-group) and patients with patellofemoral instability treated by reconstruction of the medial patellofemoral ligament (MPOAT-group) were examined. After a minimum follow-up of 3 years they were clinically evaluated with Tegner, Kujala, and IKDC scores. Furthermore, the retropatellar surface was assessed with standardized MRI obtained at final follow-up by applying the MOCART 2.0 score. Due to data distribution, group comparisons were performed with Mann-Whitney-U test.
Results
26 (POAT-group: 14, MPOAT-group: 12) patients with an average age at surgery of 28.2 ±9.9 (mean ±SD) years were assessed 7.9 ±2.8 (mean ±SD) years after surgery. There were no significant differences for Tegner (p = 0.238; 4.4 ±1.8 vs. 3.8 ±1.2, mean ±SD), Kujala (p = 0.247; 77.6 ±17.7 vs. 70.4 ±14.4, mean ±SD), and IKDC (p = 0.216; 73.2 ± 17.2 vs. 68.8 ± 10.6, mean ±SD) scores between POAT-group and MPOAT-group. The MOCART 2.0 score (55.7 ±13.2 vs. 43.3 ±22.0; mean ±SD) showed no significant (p = 0.233) difference between POAT-group and MPOAT-group. No patellofemoral redislocation occurred in the MPOAT group.
Conclusion
Autologous osteochondral transplantation for retropatellar chondral lesions results in good clinical and MRI long-term results in patellofemoral stable patients as well as patients with re-established patellofemoral stability.