Autologous osteochondral grafts in the treatment of cartilage defects of the knee joint.

Autologous osteochondral grafting (mosaicplasty) was performed on 18 patients with grade IV cartilage defects of the knee joint. The average age of these 12 men and 6 women was 36 years, follow-up time was 27.2 months and defect size was 252 mm(2) (18 x 14 mm). After plain anteroposterior and lateral radiographs and MRI (STIR sequence) examination, diagnostic arthroscopy was performed, followed by autologous osteochondral grafting, avoidance of weight bearing for 6-8 weeks, physiotherapy and continuous passive motion. All patients showed, radiologically (MRI), a full coverage of the defect with articular surface congruity postoperatively. The postoperative ICRS score was normal for 12 and nearly normal for 6 patients. Seven patients showed early persistent joint effusion for an average of 5.3 months. Hyaline-like cartilage coverage was found in four patients on second-look arthroscopy. The transplantation of autologous osteochondral grafts is being applied in an effort to reconstruct the affected articular surface with properties similar to those of hyaline cartilage. This method retains the integrity and function of a damaged joint, providing promising results in terms of preventing the development of early arthritis in young patients.