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Donor Site Evaluation After Autologous Osteochondral Mosaicplasty for Cartilaginous Lesions of the Elbow Joint

Norimasa Iwasaki, MD, PhD^,*, Hiroyuki Kato, MD, PhD, Tamotsu Kamishima, MD, PhD, Naoki Suenaga, MD, PhD and Akio Minami, MD, PhD

From the Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Sapporo, Japan, Department of Orthopaedic Surgery, Shinsyu University School of Medicine, Matsumoto, Japan, and Department of Radiology, Hokkaido University School of Medicine, Sapporo, Japan

^* Address correspondence to Norimasa Iwasaki, MD, PhD, Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Kita 15, Nishi 7, Sapporo 060-8638, Japan (e-mail: niwasaki{at}med.hokudai.ac.jp).

Background: One significant disadvantage of autologous osteochondral mosaicplasty (mosaicplasty) is the harvesting of osteochondral grafts from the normal articular area of the knee joint. However, the effect of harvesting grafts on knee function remains unclear.

Purpose: To clarify the functional effects on the donor knee of harvesting osteochondral grafts and to perform magnetic resonance imaging evaluation of donor site repair after mosaicplasty for capitellar osteochondritis dissecans in young athletes.

Study Design: Case series; Level of evidence, 4.

Methods: Eleven male competitive athletes with advanced lesions of capitellar osteochondritis dissecans underwent mosaicplasties. The surgical technique involves obtaining small-sized cylindrical osteochondral grafts from the lateral periphery of the femoral condyle at the level of the patellofemoral joint and transplanting them to osteochondral defects in the capitellum. Assessment at a mean follow-up of 26 months included local findings of the donor knees, a Lysholm knee scoring scale, International Knee Documentation Committee standard evaluation form, and magnetic resonance imaging evaluation.

Results: All patients returned to a competitive level of their previous sports without any donor site disturbances. Based on the Lysholm knee score and International Knee Documentation Committee evaluation form, all knees were graded as excellent and normal, respectively. The magnetic resonance imaging showed 50% to 100% defect fill in 6 of 9 patients and normal or nearly normal signals in 4 patients at the donor sites.

Conclusion: No adverse effects of osteochondral graft harvest on donor knee function were found after mosaicplasty for capitellar osteochondritis dissecans in young athletes. However, magnetic resonance imaging indicates that the donor site is resurfaced with fibrous tissue.

Key Words: mosaicplasty • donor site • osteochondritis dissecans (OCD) • elbow joint • knee joint