scholarly journals Osteochondral Lesions of the Talus: Few Patients Require Surgery

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0005
Author(s):  
Seung-Hwan Park ◽  
Sang Gyo Seo ◽  
Ho Seong Lee
Keyword(s):  
Osteochondral Lesion ◽  
Lesion Size ◽  
Nonoperative Treatment ◽  
Osteochondral Lesions ◽  
Sports Activity ◽  
Sf 36 ◽  
Outcome Scores ◽  
The Mean ◽  
Analogue Scales

Category: Ankle, Ankle Arthritis Introduction/Purpose: The frequency of progression of osteoarthritis and persistence of symptoms in untreated osteochondral lesion of the talus (OCL) is not well known. We report the outcome of a nonoperative treatment for symptomatic OCL. Methods: This study included 142 patients with OCLs from 2003 to 2013. The patients did not undergo immobilization and had no restrictions of physical activities. The mean follow-up time was 6 (3–10) years. Initial MRI and CT confirmed OCL and showed lesion size, location, and stage of the lesion. Progression of osteoarthritis was evaluated by standing radiographs. In 83 patients, CT was performed at the final follow-up for analyses of the lesion size. We surveyed patients for limitations of sports activity, and Visual Analogue Scales (VAS), AOFAS, and SF-36 were assessed. Results: No patients had progression of osteoarthritis. The lesion size as determined by CT did not change in 69/83 patients, decreased in 5, and increased in 9. The mean VAS score of the 142 patients decreased from 3.8 to 0.9 (p < 0.001), the mean AOFAS ankle–hindfoot score increased from 86 to 93 (p < 0.001), and the mean SF-36 score increased from 52 to 72 (p < 0.001). Only 9 patients reported limitations of sports activity. The size and location of the lesion did not correlate with any of the outcome scores. Conclusion: Nonoperative treatment can be considered a good option for patients with OCL.

No Difference in Outcomes Following Osteochondral Allograft with Fresh Precut Cores Compared to Hemi-Condylar Allografts

Cartilage ◽  
2021 ◽  
pp. 194760352110219
Author(s):  
Danielle H. Markus ◽  
Anna M. Blaeser ◽  
Eoghan T. Hurley ◽  
Brian J. Mannino ◽  
Kirk A. Campbell ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Knee Injury ◽  
Lesion Size ◽  
Osteochondral Allograft ◽  
Osteochondral Lesions ◽  
Radiographic Outcomes ◽  
Significant Difference ◽  
Patient Reported ◽  
The Mean

Objective The purpose of the current study is to evaluate the clinical and radiographic outcomes at early to midterm follow-up between fresh precut cores versus hemi-condylar osteochondral allograft (OCAs) in the treatment of symptomatic osteochondral lesions. Design A retrospective review of patients who underwent an OCA was performed. Patient matching between those with OCA harvested from an allograft condyle/patella or a fresh precut allograft core was performed to generate 2 comparable groups. The cartilage at the graft site was assessed with use of a modified Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) scoring system and patient-reported outcomes were collected. Results Overall, 52 total patients who underwent OCA with either fresh precut OCA cores ( n = 26) and hemi-condylar OCA ( n = 26) were pair matched at a mean follow-up of 34.0 months (range 12 months to 99 months). The mean ages were 31.5 ± 10.7 for fresh precut cores and 30.9 ± 9.8 for hemi-condylar ( P = 0.673). Males accounted for 36.4% of the overall cohort, and the mean lesion size for fresh precut OCA core was 19.6 mm2 compared to 21.2 mm2 for whole condyle ( P = 0.178). There was no significant difference in patient-reported outcomes including Visual Analogue Scale, Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, and Tegner ( P > 0.5 for each), or in MOCART score (69.2 vs. 68.3, P = 0.93). Conclusions This study found that there was no difference in patient-reported clinical outcomes or MOCART scores following OCA implantation using fresh precut OCA cores or size matched condylar grafts at early to midterm follow-up.

Arthroscopic Microfracture for Osteochondral Lesions of the Talus: Functional Outcomes at a Mean of 6.7 Years in 165 Consecutive Ankles

2019 ◽  
Vol 48 (1) ◽  
pp. 153-158 ◽  
Author(s):  
Seung-Won Choi ◽  
Gun-Woo Lee ◽  
Keun-Bae Lee
Keyword(s):  
Functional Outcomes ◽  
Short Form ◽  
Arthroscopic Surgery ◽  
Case Series ◽  
Osteochondral Lesions ◽  
Study Cohort ◽  
Arthroscopic Microfracture ◽  
Sf 36 ◽  
The Mean

Background: Arthroscopic microfracture for osteochondral lesions of the talus (OLT) has shown good functional outcomes. However, some studies have reported that functional outcomes deteriorate over time after surgery. Purpose: To use various functional scoring systems to evaluate functional outcomes in a large sample of patients with OLT treated by arthroscopic microfracture. Study Design: Case series; Level of evidence, 4. Methods: The study cohort consisted of 165 ankles (156 patients) that underwent arthroscopic microfracture for small to mid-sized OLT. The mean lesion size was 73 mm2 (range, 17-146 mm2), and the mean follow-up period was 6.7 years (range, 2.0-13.6 years). The Foot and Ankle Outcome Score (FAOS), American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale, visual analog scale (VAS) for pain, and 36-Item Short Form Health Survey (SF-36) were used to compare the functional outcomes between the preoperative and final follow-up assessments. Results: The mean FAOS significantly improved in regard to all subscores ( P < .001). The AOFAS ankle-hindfoot scale showed an improvement from 71.0 points (range, 47.0-84.0) preoperatively to 89.5 points (range, 63.0-100) at the final follow-up ( P < .001). The VAS score showed an improvement from 6.2 points (range, 4.0-9.0) preoperatively to 1.7 points (range, 0-6.0) at the final follow-up ( P < .001). The mean SF-36 score improved from 62.4 points (range, 27.4-76.6) preoperatively to 76.2 points (range, 42.1-98.0) at the final follow-up ( P < .001). Among 165 ankles, 22 ankles (13.3%) underwent repeat arthroscopic surgery for evaluation of repaired cartilage status. Conclusion: Arthroscopic microfracture showed good functional outcomes and improved quality of life with maintenance of satisfactory outcomes at a mean follow-up of 6.7 years. Therefore, arthroscopic microfracture seems to be reliable as a first-line treatment for OLT at an intermediate-term follow-up.

Lesion Size Is a Predictor of Clinical Outcomes After Bone Marrow Stimulation for Osteochondral Lesions of the Talus: A Systematic Review

2016 ◽  
Vol 45 (7) ◽  
pp. 1698-1705 ◽  
Author(s):  
Laura Ramponi ◽  
Youichi Yasui ◽  
Christopher D. Murawski ◽  
Richard D. Ferkel ◽  
Christopher W. DiGiovanni ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Lesion Size ◽  
Osteochondral Lesions ◽  
Lesion Area ◽  
Bone Marrow Stimulation ◽  
Marrow Stimulation ◽  
Mean Diameter ◽  
The Mean

Background: The critical lesion size treated with bone marrow stimulation (BMS) for osteochondral lesions of the talus (OLTs) has been 150 mm2 in area or 15 mm in diameter. However, recent investigations have failed to detect a significant correlation between the lesion size and clinical outcomes after BMS for OLTs. Purpose: To systematically review clinical studies reporting both the lesion size and clinical outcomes after BMS for OLTs. Study Design: Systematic review. Methods: A systematic search of the MEDLINE and EMBASE databases was performed in March 2015 based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Included studies were evaluated with regard to the level of evidence (LOE), quality of evidence (QOE), lesion size, and clinical outcomes. Results: Twenty-five studies with 1868 ankles were included; 88% were either LOE 3 or 4, and 96% did not have good QOE. The mean area was 103.8 ± 10.2 mm2 in 20 studies, and the mean diameter was 10.0 ± 3.2 mm in 5 studies. The mean American Orthopaedic Foot and Ankle Society score improved from 62.4 ± 7.9 preoperatively to 83.9 ± 9.2 at a mean 54.1-month follow-up in 14 studies reporting both preoperative and postoperative scores with a mean follow-up of more than 2 years. A significant correlation was found in 3 studies, with a mean lesion area of 107.4 ± 10.4 mm2, while none was reported in 8 studies, with a mean lesion area of 85.3 ± 9.2 mm2. The lesion diameter significantly correlated with clinical outcomes in 2 studies (mean diameter, 10.2 ± 3.2 mm), whereas none was found in 2 studies (mean diameter, 8.8 ± 0.0 mm). However, the reported lesion size measurement method and evaluation method of clinical outcomes widely varied among the studies. Conclusion: An assessment of the currently available data does suggest that BMS may best be reserved for OLT sizes less than 107.4 mm2 in area and/or 10.2 mm in diameter. Future development in legitimate prognostic size guidelines based on high-quality evidence that correlate with outcomes will surely provide patients with the best potential for successful long-term outcomes.

scholarly journals Bone marrow stimulation for talar osteochondral lesions at long-term follow-up shows a high sports participation though a decrease in clinical outcomes over time

2020 ◽  
Author(s):  
Kaj T. A. Lambers ◽  
Jari Dahmen ◽  
J. Nienke Altink ◽  
Mikel L. Reilingh ◽  
Christiaan J. A. van Bergen ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Osteochondral Lesions ◽  
Bone Marrow Stimulation ◽  
Sports Activity ◽  
Marrow Stimulation ◽  
Long Term Follow Up ◽  
The Mean ◽  
Over Time

Abstract Purpose Although bone marrow stimulation (BMS) as a treatment for osteochondral lesions of the talus (OCLT) shows high rates of sport resumption at short-term follow-up, it is unclear whether the sports activity is still possible at longer follow-up. The purpose of this study was, therefore, to evaluate sports activity after arthroscopic BMS at long-term follow-up. Methods Sixty patients included in a previously published randomized-controlled trial were analyzed in the present study. All patients had undergone arthroscopic debridement and BMS for OCLT. Return to sports, level, and type were assessed in the first year post-operative and at final follow-up. Secondary outcome measures were assessed by standardized questionnaires with use of numeric rating scales for pain and satisfaction and the Foot and Ankle Outcome Score (FAOS). Results The mean follow-up was 6.4 years (SD ± 1.1 years). The mean level of activity measured with the AAS was 6.2 pre-injury and 3.4 post-injury. It increased to 5.2 at 1 year after surgery and was 5.8 at final follow-up. At final follow-up, 54 patients (90%) participated in 16 different sports. Thirty-three patients (53%) indicated they returned to play sport at their pre-injury level. Twenty patients (33%) were not able to obtain their pre-injury level of sport because of ankle problems and eight other patients (13%) because of other reasons. Mean NRS for pain during rest was 2.7 pre-operative, 1.1 at 1 year, and 1.0 at final follow-up. Mean NRS during activity changed from 7.9 to 3.7 to 4.4, respectively. The FAOS scores improved at 1 year follow-up, but all subscores significantly decreased at final follow-up. Conclusion At long-term follow-up (mean 6.4 years) after BMS for OCLT, 90% of patients still participate in sports activities, of whom 53% at pre-injury level. The AAS of the patients participating in sports remains similar pre-injury and post-operatively at final follow-up. A decrease over time in clinical outcomes was, however, seen when the follow-up scores at 1 year post-operatively were compared with the final follow-up. Level of evidence Level II.

Clinical Outcomes of Osteochondral Lesions of the Tibial Plafond Following Arthroscopic Microfracture

2019 ◽  
Vol 40 (9) ◽  
pp. 1018-1024
Author(s):  
Wonyong Lee ◽  
Sterling Tran ◽  
Minton T. Cooper ◽  
Joseph S. Park ◽  
Venkat Perumal
Keyword(s):  
Clinical Outcomes ◽  
Osteochondral Lesions ◽  
Return To Sports ◽  
Functional Evaluation ◽  
Sports Activity ◽  
Arthroscopic Microfracture ◽  
Tibial Plafond ◽  
Functional Scores ◽  
The Mean

Background: The purpose of this study was to evaluate the clinical outcomes and the level of sports activity following arthroscopic microfracture for osteochondral lesions of the tibial plafond. Methods: A retrospective review was conducted for patients who underwent arthroscopic microfracture surgery for osteochondral lesions of the tibial plafond from January 2014 to June 2017. For functional evaluation, the visual analog scale (VAS) pain score, Foot and Ankle Ability Measure (FAAM) score, and Short Form-12 (SF-12) general health questionnaire were used. We also investigated the level of sports activity before and after the surgery. Sixteen patients were included in this study, and the mean follow-up period was 29.8 months. Results: The mean VAS score improved from 8.3 (range, 6-10) preoperatively to 1.8 (range, 0-4) postoperatively. The mean FAAM score was improved from 57.6 (range, 6.0-88.9) for the activities of daily living subscale and 34.5 (range, 3.1-92.6) for the sports subscale to 84.3 (range, 46.4-100.0) and 65.2 (range, 23.3-55.1) for each subscale, respectively, at the final follow-up. There were also improvements in the SF-12 score, from 36.3 (range, 23.3-55.1) preoperatively to 46.0 (range, 18.9-56.6) postoperatively for the SF-12 PCS, and from 41.3 (range, 14.2-65.0) preoperatively to 52.6 (range, 32.8-60.8) postoperatively for the SF-12 MCS. All functional scores showed significant differences clinically and statistically at the final follow-up. The level of sports activity after the surgery was significantly lower than their level before the surgery ( P = .012). Conclusion: Arthroscopic microfracture provided satisfactory clinical outcomes for osteochondral lesions of the tibial plafond. Though all the patients in this study were able to return to sports activity after the surgery, the postoperative level of sports activity was significantly lower than their preoperative level. Level of Evidence: Level IV, retrospective case series.

scholarly journals Arthroscopic Bone Marrow Stimulation in the Treatment of Osteochondral Lesions of the Talus

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0009
Author(s):  
Kwang Hwan Park ◽  
JaeHan Park ◽  
Jai Bum Kwon ◽  
Seung Hwan Han ◽  
Jin Woo Lee
Keyword(s):  
Bone Marrow ◽  
Clinical Outcomes ◽  
Osteochondral Lesion ◽  
Osteochondral Lesions ◽  
Bone Marrow Stimulation ◽  
Marrow Stimulation ◽  
Operation Rate ◽  
The Mean

Category: Arthroscopy Introduction/Purpose: Arthroscopic bone marrow stimulation for osteochondral lesions of the talus (OLT) has presented promising clinical outcomes in recent studies. However, there were few studies which had investigated long-term clinical outcomes. The purpose of this study is to evaluate the long-term outcomes of arthroscopic bone marrow stimulation for osteochondral lesion of the talus and to identify prognostic factors that affect the outcome. Methods: Between January 2001 and December 2007, 159 patients (172 ankles) with OLT underwent arthroscopic bone marrow stimulation as a primary surgery. Clinical outcomes were assessed using visual analog scale (VAS), American Orthopaedic Foot & Ankle Society (AOFAS) scores, Foot and Ankle Outcome Score (FAOS) and re-operation rate. Factors associated with re-operation were evaluated using bivariate analysis. Kaplan-Meier plot showed survival outcomes of OLT in long-term follow-up. Results: The mean follow-up time was 12.7 years (range 10.1-16.8) and the mean size of the lesion was 105.4 mm2 (range 19.8- 322.8). The mean VAS improved from 7.21 ± 1.71 to 1.76 ± 1.60. The mean preoperative AOFAS score was 57.98 ±14.43 and the mean postoperative AOFAS was 82.91 ± 11.58. FAOS at the time of final follow-up was comparable with those of previous literatures which showed outcomes of surgical treatments of OLT in short- and mid-term follow-up. Re-operation rate was 6.40% (11 patients with 12 revision surgery) including seven cases of re-arthroscopic bone marrow stimulation, and five cases of OAT. According to bivariate analysis, significant factor associated with re-operation was large sized OLT in preoperative MRI measurement. Conclusion: Arthroscopic bone marrow stimulation for osteochondral lesion of the talus has made satisfactory clinical outcomes through long-term follow-up over 10 years.

scholarly journals Long-term Prognosis After Successful Nonoperative Treatment of Osteochondral Lesions of the Talus: An Observational 14-Year Follow-up Study

2020 ◽  
Vol 8 (6) ◽  
pp. 232596712092418 ◽  
Author(s):  
Lizzy Weigelt ◽  
Christoph J. Laux ◽  
Lukas Urbanschitz ◽  
Norman Espinosa ◽  
Georg Klammer ◽  
...  
Keyword(s):  
Nonoperative Treatment ◽  
Osteochondral Lesions ◽  
Ankle Pain ◽  
Ankle Osteoarthritis ◽  
Aofas Score ◽  
Sports Activity ◽  
Long Term Prognosis ◽  
Tegner Score

Background: Little is known about the long-term prognosis of osteochondral lesions of the talus (OLTs) after nonoperative treatment. Purpose: To evaluate the clinical and radiological long-term results of initially successfully treated OLTs after a minimum follow-up of 10 years. Study Design: Case series; Level of evidence, 4. Methods: Between 1998 and 2006, 48 patients (50 ankles) with OLTs were successfully treated nonoperatively. These patients were enrolled in a retrospective long-term follow-up, for which 24 patients could not be reached or were available only by telephone. A further 2 OLTs (6%) that had been treated surgically were excluded from the analysis and documented as failures of nonoperative treatment. The final study group of 22 patients (mean age at injury, 42 years; range, 10-69 years) with 24 OLTs (mean size, 1.4 cm2; range, 0.2-3.8 cm2) underwent clinical and radiological evaluation after a mean follow-up of 14 years (range, 11-20 years). Ankle pain was evaluated with a visual analog scale (VAS), ankle function with the American Orthopaedic Foot and Ankle Society (AOFAS) score, and sports activity with the Tegner score. Progression of ankle osteoarthritis was analyzed based on plain ankle radiographs at the initial presentation and the final follow-up according to the Van Dijk classification. Results: At final follow-up, the 24 cases (ie, ankles) showed a median VAS score of 0 (IQR, 0.0-2.25) and a median AOFAS score of 94.0 (IQR, 85.0-100). Pain had improved in 18 cases (75%), was unchanged in 3 cases (13%), and had increased in 3 cases (13%). The median Tegner score was 4.0 (IQR, 3.0-5.0). Persistent ankle pain had led to a decrease in sports activity in 38% of cases. At the final follow-up, 11 cases (73%) showed no progression of ankle osteoarthritis and 4 cases (27%) showed progression by 1 grade. Conclusion: Osteochondral lesions of the talus that successfully undergo an initial nonoperative treatment period have minimal symptoms in the long term, a low failure rate, and no relevant ankle osteoarthritis progression. However, a decrease in sports activity due to sports-related ankle pain was observed in more than one-third of patients.

Bone Marrow Stimulation for Osteochondral Lesions of the Talus: Are Clinical Outcomes Maintained 10 Years Later?

2021 ◽  
pp. 036354652199247
Author(s):  
Jae Han Park ◽  
Kwang Hwan Park ◽  
Jae Yong Cho ◽  
Seung Hwan Han ◽  
Jin Woo Lee
Keyword(s):  
Prognostic Factors ◽  
Clinical Outcomes ◽  
Revision Surgery ◽  
Lesion Size ◽  
Osteochondral Lesions ◽  
Bone Marrow Stimulation ◽  
Factors Associated ◽  
The Mean

Background: Arthroscopic bone marrow stimulation (BMS) is considered the first-line treatment for osteochondral lesions of the talus (OLTs). However, the long-term stability of the clinical success of BMS remains unclear. Purpose: To investigate the long-term clinical outcomes among patients who underwent BMS for OLT and to identify prognostic factors for the need for revision surgery. Study Design: Case series; Level of evidence, 4. Methods: A retrospective analysis was performed on 202 ankles (189 patients) that were treated with BMS for OLT and had a minimum follow-up of 10 years. The visual analog scale for pain, American Orthopaedic Foot & Ankle Society ankle-hindfoot score, and the Foot and Ankle Outcome Score (FAOS) were assessed by repeated measures analysis of variance. Prognostic factors associated with revision surgery were evaluated with Cox proportional hazard regression models and log-rank tests. Results: The mean lesion size was 105.32 mm2 (range, 19.75-322.79); 42 ankles (20.8%) had large lesions (≥150 mm2). The mean visual analog scale for pain improved from 7.11 ± 1.73 (mean ± SD) preoperatively to 1.44 ± 1.52, 1.46 ± 1.57, and 1.99 ± 1.67 at 1, 3 to 6, and ≥10 years, respectively, after BMS ( P < .001). The mean ankle-hindfoot score also improved, from 58.22 ± 13.57 preoperatively to 86.88 ± 10.61, 86.17 ± 10.23, and 82.76 ± 11.65 at 1, 3 to 6, and ≥10 years after BMS ( P < .001). The FAOS at the final follow-up was 82.97 ± 13.95 for pain, 81.81 ± 14.64 for symptoms, 83.49 ± 11.04 for activities of daily living, 79.34 ± 11.61 for sports, and 78.71 ± 12.42 for quality of life. Twelve ankles underwent revision surgery after a mean 53.5 months. Significant prognostic factors associated with revision surgery were the size of the lesion (preoperative magnetic resonance imaging measurement ≥150 mm2; P = .014) and obesity (body mass index ≥25; P = .009). Conclusion: BMS for OLT yields satisfactory clinical outcomes at a mean follow-up of 13.9 years. The success of the surgery may depend on the lesion size and body mass index of the patient.

scholarly journals Management of Hepple Stage V Osteochondral Lesion of the Talus with a Platelet-Rich Plasma Scaffold

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Wenqi Gu ◽  
Tanzhu Li ◽  
Zhongmin Shi ◽  
Guohua Mei ◽  
Jianfeng Xue ◽  
...  
Keyword(s):  
Bone Graft ◽  
Cancellous Bone ◽  
Platelet Rich Plasma ◽  
Short Form ◽  
Osteochondral Lesion ◽  
Osteochondral Lesions ◽  
Cancellous Bone Graft ◽  
Sf 36 ◽  
American Orthopaedic

There has been no consensus on the treatment or prognosis of Hepple stage V osteochondral lesions of the talus (OLTs), especially for lesions greater than 1.5 cm2in size. The objective of this study was to investigate the clinical outcomes achieved upon application of a platelet-rich plasma (PRP) scaffold with a cancellous bone autograft for Hepple stage V OLTs. Fourteen patients (mean age, 39 years) were treated with a cancellous bone graft and a PRP scaffold between 2013 and 2015. The mean time to surgical treatment was 23.5 months. Ankle X-ray and magnetic resonance imaging were performed at the final follow-up. Functional outcomes were evaluated according to the Visual Analog Scale (VAS) score, American Orthopaedic Foot and Ankle Society (AOFAS) score, and Short Form 36 (SF-36) score. The range of motion (ROM) of the ankle joint and complications also were recorded. Thirteen patients completed the full follow-up, with a mean follow-up duration of 18 months. MRI demonstrated the complete regeneration of subchondral bone and cartilage in all patients. The postoperative VAS, AOFAS ankle and hindfoot, and SF-36 scores were improved significantly (allP<0.001) without obvious complications. We suggest that, for the Hepple stage V OLTs, management with cancellous bone graft and PRP scaffold may be a safe and effective treatment.

scholarly journals Osteochondral autograft of patella. Experience up to 10 years of follow-up

2018 ◽  
Vol 6 (12_suppl5) ◽  
pp. 2325967118S0020
Author(s):  
David Figueroa Poblete ◽  
Jaime Esteban Espinoza Valdés ◽  
Juan José Sotomayor ◽  
Luis O´Conell
Keyword(s):  
Osteochondral Lesion ◽  
Young Patients ◽  
Womac Score ◽  
Optimal Treatment ◽  
Full Thickness ◽  
Osteochondral Transplantation ◽  
Autologous Osteochondral Transplantation ◽  
Sports Activity ◽  
The Mean

Introduction: The optimal treatment of an osteochondral patellar lesion remains controversial. Autologous osteochondral transplantation shows promising outcomes, although there is scarce evidence. Objective: Present a 10-year follow-up experience and outcomes of patients with a full-thickness defect of the patella at our institution. Methods: Retrospective analysis of all the patients treated with autologous osteochondral transplantation between 2007-2018 for a patellar osteochondral lesion (ICRS IV). We analyzed the WOMAC score and demographic characteristics with IBM SPSS (IBM Corp. Released 2017. IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp). Results: A total of 14 patients (age range 15-49 years) were included. The right knee, medial facet, and the medial patellofemoral ligament (69%) were the anatomical sections and associated injuries most frequently encountered. The mean lesion area was of 1.32 cm2, with 55% requiring 2 autologous osteochondral transplantations (size range 8-10 mm2). The mean WOMAC score was 97% (91% Pain, 87% Stiffness, 95% Physical function), with a tendency of an inverse relation with age (p=0.227). Conclusion: Full-thickness defects of patellar cartilage are seen frequently in young patients. These lesions affect their quality of life, sports activity, and physical functionality. However, our outcomes at medium-term follow-up (Mean WOMAC 97), despite it is a small cohort, are promising. Long-term follow-up studies on this topic are encouraged to suggest an optimal treatment based on high-quality evidence.

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