Autologous osteochondral transplantation using the diamond bone-cutting system (DBCS): 6-12 years' follow-up of 35 patients with osteochondral defects at the knee joint

Thirty-five patients with severe osteochondral defects were treated by auto logous osteochondral transplantation between 1986 and 1992. The majority of patients (27) suffered from osteochondrosis dissecans, while 8 patients pr esented with posttraumatic osteochondral defects. The grafts were harvested with a diamond bone cutter from the posterior part of the medial or latera l femoral condyle. In 29 patients the lesion was located at the lateral par t of the medial femoral condyle, in 3 it was at the lateral femoral condyle , and in 3 at the patella. Twenty-nine patients could be examined at the fo llow-up between 6 and 12 years later (mean follow up 8.1 years). Using the standard cartilage evaluation form, the transplanted knees of 12 patients w ere graded as normal (grade I), 14 knees were nearly normal (grade II), whi le 3 patients presented with an abnormal result (grade III). All 3 of them had a varus malalignment and refused a high tibial correction osteotomy aga inst our advice. No patient was assessed as severely abnormal (grade IV). T he majority of patients improved their activity level and the functional st atus of the joint. Twelve patients developed new radiological signs of oste oarthrosis with a decrease in the radiological score of Kellgren and Lawren ce by about one stage. We conclude that autologous osteochondral transplant ation with the diamond bone-cutting system is an effective method in the tr eatment of severe osteochondral defects.