Arthroscopic osteochondral transplantation: Histologic results

Purpose: Localized, full-thickness articular cartilage defects of the femor al condyle are challenging. This report presents the histology of clinical cases obtained at intervals from 2 to 12 months after arthroscopic osteocho ndral transplantation. Type of Study: Longitudinal cohort study. Methods: P atients found at arthroscopy to have full-thickness femoral condyle defects between 1 and 3.5 cm in diameter underwent arthroscopic osteochondral tran splantation. Exclusion criteria were associated tibial defects, patellar de fects, or generalized arthritic change. The grafts taken from the superior and lateral intercondylar femoral notch were press-fit into holes drilled i nto the defect starting adjacent to the articular cartilage margin. Cancell ous bone bridges were maintained between grafts. At various time intervals from 2 to 12 months after the osteochondral transplantation, arthroscopic b iopsy specimens of the recipient sites were obtained. Results: Ten patients (5 male, 5 female) enrolled at 2 centers were evaluated arthroscopically a t various intervals up to 13 months after osteochondral transplantation. Th e average patient age was 40 years (range, 17 to 65 years). One to 3 plugs had been harvested and inserted. Seven patients underwent biopsy at interva ls ranging up to 12 months postoperatively. All showed maintenance of the i ntegrity of the grafts with living chondrocytes and osteocytes. Donor sites filled without grafting and were covered with fibrocartilagenous scar. No complications occurred in this group. Conclusions: These histologic results suggest that arthroscopic osteochondr al transplantation is a viable alternative for treating full-thickness chon dral defects, with the grafts retaining their integrity and living chondroc ytes and osteocytes observed in the grafts for up to 12 months after implan tation.