[Mosaicplasty in articular cartilage injuries of the knee]

Articular cartilage has little ability to regenerate. Cartilage lesions usually persist, may provoke pain, swelling, locking and disability, and may predispose for development of osteoarthritis. Long-term results after traditional surgical techniques are unsatisfactory. In recent years, auto-transplantation of chondrocytes and osteochondral cylinder grafts aimed at reconstituting the chondral surface has been introduced. By the mosaicplasty technique, osteochondral grafts are transplanted from areas of little weight bearing at the outer limits of the trochlea to the focal lesion in the same knee. Since March 1998, 35 consecutive mosaicplasties in 33 patients (median age 35 years) have been performed at our hospital. The median area of the lesions was 2.8 sq. cm and the lesions were located at the femoral condyles, trochlea or patella. Six to twelve months post-operatively we found significant improvement of the Lysholm kneescore, from 40 (SD 14) pre-operatively to 84 (SD 14) (p < 0.001), and on the Cincinnati kneescore (pain, swelling, giving way, catching and as total evaluation). Short-term results are good regarding symptoms and knee function. The method is some-what complicated, especially when performed arthroscopically. There are few complications. Mosaicplasty may be considered in cartilage lesions of moderate size (1 to 5 sq. cm) on the femoral condyles, trochlea and patella.