A new point of view for mosaicplasty in the treatment of focal cartilage defects of knee joint: honeycomb pattern

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dc.authorid0000-0002-5772-5630
dc.authorscopusid56911998800
dc.authorscopusid26967708000
dc.authorwosidKarakoyun, Özgür/AAN-9431-2020
dc.authorwosidkarakoyun, ozgur/G-9522-2013
dc.contributor.authorErol, Mehmet Fatih
dc.contributor.authorKarakoyun, Özgür
dc.date.accessioned2022-05-11T14:36:12Z
dc.date.available2022-05-11T14:36:12Z
dc.date.issued2016
dc.departmentFakülteler, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Ortopedi ve Travmatoloji Ana Bilim Dalı
dc.description.abstractBackground: A focal full thickness cartilage lesion of knee joint is one of the commonly seen intraarticular pathologies among the joint cartilage problems. Osteochondral autograft transfer mosaicplasty is a method which has satisfactory outcomes among the treatment preferences of cartilage defects. In spite of the favorable clinical results there are some pitfalls of mosaicplasty treatment especially in cases of large defects. One of the major problems of the classical OAT mosaicplasty is the gap spaces between the plugs. The objective of the present study is to report the early clinical and radiological outcomes and to evaluate the clinical application of a new hexagonal osteochondral graft system (HOGS) with the hypothesis of improvement of the OAT mosaicplasty method with the use of hexagonally shaped plugs. The study has intended to answer two questions. (1) Does mosaicplasty with the new HOGS has favorable early clinical outcomes? (2) Is it possible to arrange the osteochondral autografts without leaving gap spaces by using hexagonal pattern in OAT mosaicplasty? Patients and methods: We designed a retrospective study to report analysis of early outcomes of the initial case series of OAT mosaicplasty by using a new HOGS. Six male individuals with the diagnosis of osteochondral defect and treated with HOGS and reached sixth month follow-up formed the basis of the study. The clinical status of the patients were evaluated with IKDC score. The radiological evaluations were carried out with direct X-rays and magnetic resonance imaging (MRI) studies. The mosaicplasty procedures were carried out via standard surgical method of classical OAT mosaicplasty by using the HOGS following a diagnostic arthroscopy in the same session. The inclusion criteria was a full thickness osteochondral lesion of femoral condyle between 1.5 and 6 cm(2) and completion of 6 month follow-ups. The patients having deformities around the knee or major ligament lesions were excluded. MOCART scoring system was used for the evaluation of follow-up MRI findings. The clinical status of the patients were evaluated with IKDC scores. Results: The mean age of the patients was 40.8 (+/- 5.2) years and the mean duration of the symptoms on presentation was 16 (+/- 4.3) months. On the initial MRI studies mean defect area was measured 3.7 cm(2) (+/- 0.9) which was compatible with arthroscopic findings. During the surgical procedures it was possible to fill the defect area completely. The mean number of plugs in this series was 4.8 (+/- 1.1). We did not faced with insufficient donor reserve problem in any of the cases. On the sixth month follow-up physical examination there was no limitation of the knee joint range of motion in the cases. All patients were able to bear weight on to their operated extremities without pain. The mean postoperative IKDC score improvement was 70.2 (+/- 3.5) which shows significant improvement compared to preoperative scores. On the control MRI studies the bone integration of the hexagonal plugs were complete the cartilage continuity of the articular surfaces were intact and the grafts were well incorporated in all cases. The mean MOCART score on the 6th month MRI studies was 65.8 (+/- 4.1). Conclusion: The early outcomes of OAT mosaicplasty with HOGS are comparable to studies on the classical mosaicplasty. According to our observations in this study we can say that the gap space left between the cylindrical plugs can be solved by using hexagonal prism shaped plugs.
dc.identifier.doi10.1186/s40064-016-2796-y
dc.identifier.issn2193-1801
dc.identifier.pmid27512629
dc.identifier.scopus2-s2.0-84979783237
dc.identifier.scopusqualityN/A
dc.identifier.urihttps://doi.org/10.1186/s40064-016-2796-y
dc.identifier.urihttps://hdl.handle.net/20.500.11776/8406
dc.identifier.volume5
dc.identifier.wosWOS:000381637800003
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorErol, Mehmet Fatih
dc.institutionauthorKarakoyun, Özgür
dc.language.isoen
dc.publisherSpringer International Publishing Ag
dc.relation.ispartofSpringerplus
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectMosaicplasty
dc.subjectFocal cartilage lesions
dc.subjectKnee
dc.subjectHoneycomb pattern
dc.subjectOsteochondral Autografting Mosaicplasty
dc.subjectAutologous Chondrocyte Implantation
dc.subjectFemoral Condyles
dc.subjectRepair
dc.subject2-Year
dc.titleA new point of view for mosaicplasty in the treatment of focal cartilage defects of knee joint: honeycomb pattern
dc.typeArticle

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