Treatment of knee osteochondritis dissecans with autologous tendon transplantation: Clinical and radiological results

BACKGROUNDDefect treatment with tendon autograft in osteochondral lesions has been published in the literature with an experimental study in dogs. To demonstrate that it is possible to treat knee osteochondral lesions with the technique of autologous tendon transplantation.AIMTo evaluate the clinical and radiological results of patients with knee osteochondral lesions who were treated with autologous tendon transplantation.METHODSTwenty patients (22 knees) with osteochondritis dissecans (OCD) lesions involving the knee were treated with autologous tendon transplantation between 2005-2018. All lesions were International Cartilage Repair Society grade IV. All patients were evaluated clinically at final follow-up with knee injury and osteoarthritis outcome score (KOOS); and radiologically with magnetic resonance observation and cartilage repair tissue (MOCART) and Kellgren-Lawrence (KL) classification.RESULTSA total of 20 patients (22 knees) with a mean age of 25.5 & PLUSMN; 6.8 years were included. The average defect size was 4.2 & PLUSMN; 2.1 cm(2), and the average defect depth was 0.9 & PLUSMN; 0.4 cm. Total KOOS score was preoperatively 29.4 & PLUSMN; 5.5 and was later found to be 81.5 & PLUSMN; 5.9 after an average of 68.7 & PLUSMN; 37.7 mo follow-up. The mean MOCART score was 56.2 & PLUSMN; 10.7. Preoperatively, all of the patients had KL grades of 0-1; during the follow-up period, 80% of the patients showed no radiological progress of osteoarthritis. Patients with less than 4 cm(2) lesion had statistically significantly better overall KOOS than patients whose more than 4 cm(2) lesion, particularly in sport and quality of life subscales.CONCLUSIONThe autologous tendon transplantation is a single-step, safe, simple, cost-effective method for the treatment of knee OCD with satisfactory clinical and radiological outcomes, particularly in patients with less than 4 cm(2) lesion.