Long-term clinical follow-up of microfracture versus mosaicplasty in articular cartilage defects of medial femoral condyle

Knee. 2017 Dec;24(6):1402-1407. doi: 10.1016/j.knee.2017.08.061. Epub 2017 Sep 27.

Abstract

Background: The purpose of this study was to evaluate the outcome after cartilage repair surgery in focal defects of the knee by microfracture versus mosaicplasty.

Methods: A cohort of 102 patients undergoing microfracture (n=52) or mosaicplasty (n=50) of a single articular cartilage defect in the medial femoral condyle of ≤50mm2 was evaluated by Lysholm score before surgery, at six months, 12months, five years, 10years, and 15-18years after surgery.

Results: Median age of patients at the time of surgery was 36years (range 16-58) and median follow-up time was 16years (range 14-18). Defects were treated with a median size of three square centimetres (range one to five). A significant increase was seen in the Lysholm score from mean 48 (SD 16) at baseline to 66 (SD 23; P<0.001) at the 15-18year follow-up. The Lysholm score was higher in the mosaicplasty group at six months, 12months, five years and 10years (P<0.05 for all comparisons). These differences were clinically significant at all points (>10 points). However, at the final follow-up, the difference (eight points) did not reach statistical significance.

Conclusions: In the short-term, medium-term and long-term (10years), mosaicplasty in a single cartilage defect size one to five square centimetres of the femoral condyle resulted in clinically relevant better outcome than microfracture. However, at 15-18years after the surgery such a difference could not be found. In the six month to 10-15year (after surgery) perspective, the mosaicplasty procedure offered a better outcome in this type of lesion.

Level of evidence: Level III.

Keywords: Articular cartilage defects; Knee; Microfracture; Microfracture (MFX); Mosaicplasty; Osteochondral autograft transfer (OAT).

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Arthroplasty, Subchondral*
  • Cartilage / transplantation*
  • Cartilage, Articular / injuries
  • Cartilage, Articular / surgery*
  • Cohort Studies
  • Female
  • Femur / surgery*
  • Femur / transplantation*
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Transplantation, Autologous
  • Young Adult