Osteochondral autologous transplantation for the treatment of full-thickness cartilage defects of the shoulder: results at nine years

J Bone Joint Surg Br. 2009 Apr;91(4):499-503. doi: 10.1302/0301-620X.91B4.21838.

Abstract

We describe the outcome at a mean follow-up of 8.75 years (7.6 to 9.8) of seven patients who had undergone osteochondral autologous transplantation for full-thickness cartilage defects of the shoulder between 1998 and 2000. These patients have been described previously at a mean of 32.6 months when eight were included. One patient has been lost to follow-up. The outcome was assessed by the Constant shoulder score and the Lysholm knee score to assess any donor-site morbidity. Standard radiographs and MR scores were obtained and compared with the pre-operative findings and the results from the previous review. No patient required any further surgery on the shoulder. The mean Constant score improved significantly until the final follow-up (p = 0.018). The Lysholm score remained excellent throughout. There was a significant progression of osteoarthritic changes from the initial surgery to the first and final follow-up but this did not appear to be related to the size of the defect, the number of cylinders required or the Constant score (p = 0.016). MRI showed that all except one patient had a congruent joint surface at the defect with full bony integration of all osteochondral cylinders. The results have remained satisfactory over a longer period with very good objective and subjective findings.

MeSH terms

  • Adult
  • Bone Transplantation / methods*
  • Cartilage, Articular / injuries*
  • Cartilage, Articular / transplantation*
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Osteoarthritis / diagnostic imaging
  • Osteoarthritis / etiology
  • Radiography
  • Severity of Illness Index
  • Shoulder Joint / diagnostic imaging
  • Shoulder Joint / injuries
  • Shoulder Joint / pathology
  • Shoulder Joint / surgery*
  • Treatment Outcome
  • Young Adult