Arthroscopic chondral osseous autograft transplantation (COR procedure) for femoral defects

Localized, full-thickness articular cartilage defects of the femoral condyle are often found unexpectedly. An arthroscopic repair technique that transplants chondral osseous replacement plugs to fill the defect (the COR technique; Mitek Products, Westwood, MA) offers an immediate solution for these lesions. The purpose of this study was to review the clinical and radiographic results of femoral chondral osseous replacement for full-thickness articular cartilage lesions between 2.5 and 1.0 cm in diameter.

Case series.

A retrospective review of a consecutive series of patients from 2 centers treated for full-thickness femoral articular cartilage lesions using a chondral osseous autograft transplantation technique was performed. All knees were evaluated both preoperatively and postoperatively by physical examination, radiographs, and Lysholm and Tegner knee scores. Inclusion criteria were full-thickness femoral condyle defects greater than 1 cm and less than 2.5 cm in diameter, and a minimum 24-month follow-up. Exclusion criteria were associated tibial defects, patellar defects, or generalized arthritic change. Grafts harvested from the superior, lateral femoral notch were press-fit into drilled holes to fill the femoral defects.

Thirty-six patients met the inclusion criteria with an average follow-up of 48 months (range, 24 to 89 months). Their average age was 43 years and there were 20 men and 16 women. The medial femoral condyle was involved in 27 cases and the lateral femoral condyle in 9. The average Lysholm score increased from 44 preoperatively to 84 at follow-up. The average Tegner score at follow-up was 5. Repeat arthroscopy was performed in 14 patients and showed good incorporation of the grafts in all cases. Radiographic examinations revealed no arthritic changes at follow-up.

This technique successfully transplants chondral osseous grafts within the knee that remain viable. No radiographic arthritic changes were observed and the midterm clinical result was favorable for these patients. Further investigation of the long-term results is required.

Level 4, no or historical control.