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J Knee Surg 2021; 34(01): 094-107
DOI: 10.1055/s-0039-1692999
Original Article

Arthroscopic versus Open Osteochondral Autograft Transplantation (Mosaicplasty) for Cartilage Damage of the Knee: A Systematic Review

Kazuha Kizaki
1   McMaster University, Department of Health Research Methods, Evidence, and Impact, Hamilton, Ontario, Canada
,
Hussein Ali El-Khechen
1   McMaster University, Department of Health Research Methods, Evidence, and Impact, Hamilton, Ontario, Canada
,
Fumiharu Yamashita
2   Kyoto Shimogamo Hospital, Department of Orthopaedic Surgery, Kyoto, Japan
,
Andrew Duong
3   McMaster University, Division of Orthopaedic Surgery, Hamilton, Ontario, Canada
,
Nicole Simunovic
3   McMaster University, Division of Orthopaedic Surgery, Hamilton, Ontario, Canada
,
Volker Musahl
4   University of Pittsburgh, Department of Orthopaedic Surgery, Pittsburgh, Pennsylvania
,
Olufemi R. Ayeni 
3   McMaster University, Division of Orthopaedic Surgery, Hamilton, Ontario, Canada
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Abstract

Osteochondral autograft transplantation (OAT) is a surgical option for repairing cartilage damage in knees, and can be performed using open or arthroscopic procedures. The aim of this review was to report clinical outcomes, postoperative complications, defect location, and defect size between open and arthroscopic OATs. Three electronic databases (EMBASE, PUBMED, and MEDLINE) were searched for relevant articles. In regard to eligibility criteria, knee articular damage cases solely treated with OAT were included and cases concomitant with ligament reconstruction, limb realignment, and meniscus repair were excluded. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and descriptive statistics are presented. A total of 24 studies were included with a total sample of 1,139 patients (532 in open OAT vs. 607 in arthroscopic OAT). Defect size in open OAT was three times larger than that of arthroscopic OAT (2.96 ± 0.76 vs. 0.97 ± 0.48 cm2). In terms of defect location, the medial femoral condyle (MFC) was the most common (75.4%), followed by the lateral femoral condyle (LFC; 12.1%), patella (6.7%), and trochlea (5.7%). All of these defect locations were treated with open OAT, whereas arthroscopic OAT treatments were restricted to the MFC and LFC. The clinical outcomes were overall favorable with the modified Hospital for Special Surgery knee scores being 89.6 ± 8.0 (36.1-month follow-up) versus 90.4 ± 6.0 (89.5-month follow-up) and the Lysholm scores being 81.6 ± 8.9 (44.2-month follow-up) and 83.3 ± 7.4 (12.0-month follow-up) between open and arthroscopic OATs, respectively. Fifty-three postoperative complications were observed (39/279 vs. 14/594) and the most common complication was hemarthrosis (13/39 in open, vs. 1/14 in arthroscopic OAT). The overall clinical outcomes were favorable in open and arthroscopic OATs, whereas open OAT allowed for treatment of lesions approximately three times greater in dimension than in arthroscopic OAT. Also, defect location was restricted to MFC and LFC in arthroscopic OAT. The most common complication was hemarthrosis.

Keywords

knee - arthroscopy - osteochondral autograft transplantation - cartilage


Publication History

Received: 01 April 2019

Accepted: 19 May 2019

Article published online:
09 July 2019

© 2020. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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