[Autologous osteochondral transplantation under arthroscope to treat cartilage defect]

To explore the methods of repairing cartilage defects and to introduce the clinical experience with the autologous osteochondral transplantation.

Twenty-five patients with chondral and osteochondral defects of the weight-bearing surfaces were treated by the autologous osteochondral transplantation for the repair of the chondral and osteochondral defects of the unweight-bearing surfaces under arthroscope. According to the shape of the defects, the different dimensions of the osteochondral autograft were selected. All the patients began the training of the continuous passive motion after operation. Six weeks after operation, the patients began to walk in the weight-bearing habitus. However, in the control group, another 25 patients were retrospectively analyzed, who had chondral and osteochondral defects of the weight-bearing surfaces but were treated only by the cleaning and drilling procedures. The scores evaluated by the Brittberg-Peterson scoring scale of the 2 group were 98. 65 +/- 9.87 and 96.98 +/- 8.94 respectively.

The follow-up for 3-24 months after operation revealed that the treated knee joint had a good motion extent. The pain was obviously alleviated. Based on the longitudinal study with the three-dimensional spoiled magnetic resonance imaging (MRI), the signal intensity of the repaired tissues approached to the normal condition. The scores evaluated by the Brittberg-Peterson scoring scale were almost zero 3 months after operation in the experimental group, and the scores were 58.48 +/- 6.98 in the control group. There were significant differences between the experimental group and the control group (P < 0.01).

Autologous osteochondral transplantation under arthroscope is a good curative method for the cartilage defects, with advantages of minimal invasiveness and avoidance of rejections resulting from allografts. However, its long-term effect needs to be further studied. The conventional therapies including cleaning and drilling are useful in alleviating the symptoms.