Articular cartilage transplantation - Clinical results in the knee

Between December 1983 and August 1991, 55 consecutive patients (55 knees) w ho underwent articular cartilage transplantation to their damaged knees wer e enrolled in the study. Average followup was 75 months (range, 11-147 mont hs). Eight-two percent were younger than 45 years of age. Patients were eva luated through an 18-point scale, with 6 points each allocated to pain, ran ge of motion, and function. An excellent knee was pain free, had full range of motion, and permitted unlimited activity. A good knee allowed full time employment and moderate activity. Eleven of 15 (73%) allografts transplant ed 10 or more years ago were still good or excellent at the time of last fo llowup. Overall, 42 of 55 (76%) knees that received the transplants were ra ted good or excellent. Specifically, 36 of 43 (84%) patients with unipolar transplants regained normal use of their resurfaced knee, The results after bipolar resurfacing were less encouraging, with only six of 12 (50%) knees rated good or excellent, The described technique of osteochondral shell al lograft resurfacing of the knee capitalizes on the different healing potent ials of bone and cartilage by transplanting the viable articular cartilage organ in its entirety along with just enough of the underlying bone to allo w for graft incorporation through creeping substitution. The results suppor t the use of fresh osteochondral shell allograft transplantation for the tr eatment of large, full thickness articular cartilage defects to the medial or lateral femoral condyles and to the patella.