Text

Objectives and questions: Treatment of osteochondral lesions remains challenging. This study evaluated clinical and radiological outcomes of a novel one-step autologous minced cartilage technique combined with subchondral bone grafting for osteochondral defects of the knee joint.

Material and methods: Twenty patients with focal osteochondral defects treated with minced cartilage technique and autologous bone grafting were retrospectively analysed. In defects ≥ 5 cm² or uncontained defects an additional coverage with an autologous synovial flap was performed. Clinical scores and MRI evaluations using MOCART2.0 scoring system were assessed at baseline and final follow-up.

Results: Mean follow-up was 28.3 ± 3.7 months. Visual analogue scale decreased significantly from 4.9 ± 1.1 preoperatively to 2.2 ± 1.9 at follow-up (p<0.0001). Tegner score improved from 2.6 ± 0.8 to 4.9 ± 1.4 (p<0.0001) and IKDC from 42.8 ± 23.1 to 81.0 ± 12.3 (p<0.0001). All KOOS subscales showed significant improvements. Average MOCART2.0 score was 74.8 ± 13.8, with 65% of patients scoring ≥70 points. Clinical improvements were independent of defect size and location.

Discussion and conclusions: This whole autologous one-step minced cartilage procedure with subchondral bone grafting demonstrated good clinical and radiological outcomes for osteochondral lesions at short-term. The technique represents a promising treatment option requiring no external tissue engineering. Further prospective studies are needed to establish long-term efficacy and to assess the superiority compared to other treatment procedures.