Arthroscppic Osteochondral Grafting Using the .Mosaicplasty Technique for the Treatment of Osteochondral Defects of the Knee Joint

Abstract

Osteochondral defects (OCD) that are symptomatic and refractory to non-operative treatment represent a clinical management challenge. In the past, the treatment ofOCD were always salvage procedures including debridement, excision and drilling and the results were not predictable. Although there have been important advances in stimulating intrinsic repmr mechanisms, cartilage regeneration and other substitution techniques, to date norte has unlocked the understanding necessary to duplicate normal articular cartilage. The ohjcctivc of treatment of cartilage lesions IS to obtain pain relief, reduce effusion and inflammation, restore function, reduce disability and postpone or alleviate the need for prosthetic replacement (Jackson, 200 I).

The etiology of OCD includes : Osteochondritis dissecans, traumatic lesions, infections, tumors, malaligned joints, degenerative arthritis.........etc.

Mosaicplasty (Multiple small sized cylindrical Osteochondral Grafting) is one ofthe new surgical techniques for the treatment ofOCD and has been developed by Laszlo Hangody in Hungary in 1991 (Beadling et al, 1998). After successful pre-clinical animal trials, this treatment option has been introduced into the clinical practice on February 1992. Mosaicplasty involves obtaining small sized cylindrical osteochondral grafts from the less weight bearing periphery of the patella-femoral joint and transplanting them in a mosaic-like fashion into a prepared defect site on the weight bearing surfaces of the target joint.