Turhan AU, Açıl S, Gül O, Öner K, Okutan AE, Ayas MS. Treatment of knee osteochondritis dissecans with autologous tendon transplantation: Clinical and radiological results. World J Orthop 2021; 12(11): 867-876 [PMID: 34888147 DOI: 10.5312/wjo.v12.i11.867]
Corresponding Author of This Article
Muhammet Salih Ayas, MD, Assistant Professor, Doctor, Department of Orthopedics and Traumatology, Erzurum Regional Training and Research Hospital, Çat Yolu Cad., Erzurum 25070, Turkey. muhammetsalihayas@yahoo.com.tr
Research Domain of This Article
Orthopedics
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Nov 18, 2021; 12(11): 867-876 Published online Nov 18, 2021. doi: 10.5312/wjo.v12.i11.867
Treatment of knee osteochondritis dissecans with autologous tendon transplantation: Clinical and radiological results
Ahmet Uğur Turhan, Sezgin Açıl, Orkun Gül, Kerim Öner, Ahmet Emin Okutan, Muhammet Salih Ayas
Ahmet Uğur Turhan, Kerim Öner, Department of Orthopedics and Traumatology, Karadeniz Technical University Faculty of Medicine, Trabzon 61080, Turkey
Sezgin Açıl, Department of Orthopedics and Traumatology, Tirebolu State Hospital, Giresun 28100, Turkey
Orkun Gül, Department of Orthopedics and Traumatology, Medical Park Trabzon Hospital, Trabzon 61080, Turkey
Ahmet Emin Okutan, Department of Orthopedics and Traumatology, Samsun Training and Research Hospital, Samsun 55100, Turkey
Muhammet Salih Ayas, Department of Orthopedics and Traumatology, Erzurum Regional Training and Research Hospital, Erzurum 25070, Turkey
Author contributions: Ayas MS, Turhan AU, Açıl S, Gül O, Öner K and Okutan AE designed the research study; Ayas MS, Turhan AU, Açıl S, Gül O, Öner K and Okutan AE performed the research, analyzed the data and wrote the manuscript; All authors have read and approve the final manuscript.
Institutional review board statement: This study was approved by the institutional review board of our hospital.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest.
Data sharing statement: The participants gave informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Muhammet Salih Ayas, MD, Assistant Professor, Doctor, Department of Orthopedics and Traumatology, Erzurum Regional Training and Research Hospital, Çat Yolu Cad., Erzurum 25070, Turkey. muhammetsalihayas@yahoo.com.tr
Received: June 17, 2021 Peer-review started: June 17, 2021 First decision: July 28, 2021 Revised: July 28, 2021 Accepted: September 16, 2021 Article in press: September 16, 2021 Published online: November 18, 2021 Processing time: 151 Days and 7.9 Hours
Abstract
BACKGROUND
Defect treatment with tendon autograft in osteochondral lesions has been published in the literature with an experimental study in dogs. To demonstrate that it is possible to treat knee osteochondral lesions with the technique of autologous tendon transplantation.
AIM
To evaluate the clinical and radiological results of patients with knee osteochondral lesions who were treated with autologous tendon transplantation.
METHODS
Twenty patients (22 knees) with osteochondritis dissecans (OCD) lesions involving the knee were treated with autologous tendon transplantation between 2005-2018. All lesions were International Cartilage Repair Society grade IV. All patients were evaluated clinically at final follow-up with knee injury and osteoarthritis outcome score (KOOS); and radiologically with magnetic resonance observation and cartilage repair tissue (MOCART) and Kellgren-Lawrence (KL) classification.
RESULTS
A total of 20 patients (22 knees) with a mean age of 25.5± 6.8 years were included. The average defect size was 4.2 ± 2.1 cm2, and the average defect depth was 0.9 ± 0.4 cm. Total KOOS score was preoperatively 29.4 ± 5.5 and was later found to be 81.5 ± 5.9 after an average of 68.7 ± 37.7 mo follow-up. The mean MOCART score was 56.2 ± 10.7. Preoperatively, all of the patients had KL grades of 0–1; during the follow-up period, 80% of the patients showed no radiological progress of osteoarthritis. Patients with less than 4 cm2 lesion had statistically significantly better overall KOOS than patients whose more than 4 cm2 lesion, particularly in sport and quality of life subscales.
CONCLUSION
The autologous tendon transplantation is a single-step, safe, simple, cost-effective method for the treatment of knee OCD with satisfactory clinical and radiological outcomes, particularly in patients with less than 4 cm2 lesion.
Core Tip: Defect treatment with tendon autograft in osteochondral lesions has been published in the literature with an experimental study in dogs. However, to date, only one case in the capitellum of the elbow has been scientifically published in humans. This retrospective study shows that knee osteochondral lesions are possible with tendon autograft transplantation technique.
