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

Background: Although some surgical techniques have been described for the operative treatment of unstable Osteochondritis dissecans (OCD) of the knee, outcomes are variable and are not satisfying totally. The aim of the present study is to evaluate the outcomes of autogenous osteochondral grafting for OCD of the knee.

Methods: In a case series study, from June 2014 to July 2015, 16 patients with stage II-IV OCD (International Cartilage Repair 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 the initial and final visits, the IKDC, Lysholm score and Tegner activity scale were evaluated.

Results: The 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 1 abnormal 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 ).

Conclusion: Surgical 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 appropriate for autogenous osteochondral grafting with healthy cartilage.