Osteochondral grafting for failed knee osteochondritis dissecans repairs

Knee. 2014 Dec;21(6):1145-50. doi: 10.1016/j.knee.2014.09.003. Epub 2014 Oct 14.


Background: Revision of failed surgical treatments of osteochondritis dissecans (OCD) lesions remains a challenge without an obvious solution. The aim of this study was to evaluate seven consecutive patients undergoing osteochondral grafting of a failed OCD repair.

Methods: The mean time from surgery to the latest evaluation was 7.0 years. IKDC, WOMAC, Tegner, and MRI studies were collected both preoperatively and during follow-up. Evaluation of the graft was assessed using the magnetic resonance observation of cartilage repair tissue (MOCART) grading system.

Results: Over the course of the study period, five patients required additional surgery with a study median of one additional surgery (range, zero to 3). At most recent follow-up, there was significant improvement from preoperative values in median IKDC (p=0.004), WOMAC (p=0.030), and Tegner (p=0.012). Complete cartilage fill and adjacent tissue integration of the paste graft were observed by MRI evaluation in five of the seven (71.4%) patients. Definitive correlation between clinical outcomes and MRI scores was not observed.

Conclusions: This study shows promising results of osteochondral grafting as a viable option for the revision of failed OCD lesion repairs; however, more patients are needed to fully support its efficacy in these challenging failed revision cases.

Keywords: Arthroscopy; Failed repair; Osteoarthritis; Osteochondral paste grafting; Osteochondritis dissecans.

MeSH terms

  • Adolescent
  • Adult
  • Arthroscopy*
  • Cartilage / transplantation*
  • Cohort Studies
  • Female
  • Humans
  • Knee Joint*
  • Magnetic Resonance Imaging
  • Male
  • Osteochondritis Dissecans / pathology*
  • Osteochondritis Dissecans / surgery*
  • Reoperation
  • Treatment Failure
  • Young Adult