Limits...
The 5.5-year results of MegaOATS--autologous transfer of the posterior femoral condyle: a case-series study.

Braun S, Minzlaff P, Hollweck R, Wörtler K, Imhoff AB - Arthritis Res. Ther. (2008)

Bottom Line: Preoperative osteoarthritis in 17 individuals was related to significant lower Lysholm scores (P = 0.014), but progression in 17 patients did not significantly influence the score results (P = 0.143).Patients significantly improve in the Lysholm score, in daily-life activity levels and in return to recreational sports.Thirty-one out of 33 patients were comfortable with the results and would undergo the procedure again.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Sportsorthopaedics, Technical University Munich, Connollystrasse 32, 80809 Munich, Germany. sebra16@mac.com

ABSTRACT

Introduction: Large osteochondral defects of the weight-bearing zones of femoral condyles in young and active patients were treated by autologous transfer of the posterior femoral condyle (large osteochondral autogenous transplantation system (MegaOATS)). The technique presented is a sound and feasible salvage procedure to address large osteochondral defects in weight-bearing zones.

Methods: Thirty-six patients between July 1996 and December 2000 were included. Thirty-three patients (10 females, 23 males) were evaluated by the Lysholm score and X-ray scans. A random sample of 16 individuals underwent magnetic resonance imaging analysis. The average age at the date of surgery was 34.3 (15 to 59) years, and the mean follow up was 66.4 (46 to 98) months. The mean defect size was 6.2 (2 to 10.5) cm2, in 27 patients affecting the medial femoral condyle and in six patients affecting the lateral femoral condyle. Trauma or osteochondrosis dissecans were pathogenetic in 82%.

Results: The Lysholm score in all 33 individuals showed a highly significant increase from a preoperative median 49.0 points to a median 86.0 points (P < or = 0.001). Twenty-seven patients returned to recreational sports. X-ray scans showed a rounding of the osteotomy edge in 24 patients, interpreted as a partial remodelling of the posterior femoral condyle. Preoperative osteoarthritis in 17 individuals was related to significant lower Lysholm scores (P = 0.014), but progression in 17 patients did not significantly influence the score results (P = 0.143). All 16 magnetic resonance imaging examinations showed vital and congruent grafts.

Conclusion: Patients significantly improve in the Lysholm score, in daily-life activity levels and in return to recreational sports. Thirty-one out of 33 patients were comfortable with the results and would undergo the procedure again. The MegaOATS technique is therefore recommended as a salvage procedure for young individuals with large osteochondral defects in the weight-bearing zone of the femoral condyle.

Show MeSH

Related in: MedlinePlus

Large osteochondral autogenous transplantation system graft press-fit placed in the prepared defect site.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2483459&req=5

Figure 4: Large osteochondral autogenous transplantation system graft press-fit placed in the prepared defect site.

Mentions: As the curvature of the posterior condyle in the sagittal plane is smaller than in the weight-bearing zone but is comparable with the coronal plane of the weight-bearing zone of the condyle, the graft in some cases was rotated 90° for a flush fit (Figure 4). In a few cases with an osteochondral defect far posterior close to the osteotomy, there was not sufficient bone support for press-fit fixation. A fixation of the graft with a minifragment screw in the previously described fashion was therefore necessary.


The 5.5-year results of MegaOATS--autologous transfer of the posterior femoral condyle: a case-series study.

Braun S, Minzlaff P, Hollweck R, Wörtler K, Imhoff AB - Arthritis Res. Ther. (2008)

Large osteochondral autogenous transplantation system graft press-fit placed in the prepared defect site.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2483459&req=5

Figure 4: Large osteochondral autogenous transplantation system graft press-fit placed in the prepared defect site.
Mentions: As the curvature of the posterior condyle in the sagittal plane is smaller than in the weight-bearing zone but is comparable with the coronal plane of the weight-bearing zone of the condyle, the graft in some cases was rotated 90° for a flush fit (Figure 4). In a few cases with an osteochondral defect far posterior close to the osteotomy, there was not sufficient bone support for press-fit fixation. A fixation of the graft with a minifragment screw in the previously described fashion was therefore necessary.

Bottom Line: Preoperative osteoarthritis in 17 individuals was related to significant lower Lysholm scores (P = 0.014), but progression in 17 patients did not significantly influence the score results (P = 0.143).Patients significantly improve in the Lysholm score, in daily-life activity levels and in return to recreational sports.Thirty-one out of 33 patients were comfortable with the results and would undergo the procedure again.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Sportsorthopaedics, Technical University Munich, Connollystrasse 32, 80809 Munich, Germany. sebra16@mac.com

ABSTRACT

Introduction: Large osteochondral defects of the weight-bearing zones of femoral condyles in young and active patients were treated by autologous transfer of the posterior femoral condyle (large osteochondral autogenous transplantation system (MegaOATS)). The technique presented is a sound and feasible salvage procedure to address large osteochondral defects in weight-bearing zones.

Methods: Thirty-six patients between July 1996 and December 2000 were included. Thirty-three patients (10 females, 23 males) were evaluated by the Lysholm score and X-ray scans. A random sample of 16 individuals underwent magnetic resonance imaging analysis. The average age at the date of surgery was 34.3 (15 to 59) years, and the mean follow up was 66.4 (46 to 98) months. The mean defect size was 6.2 (2 to 10.5) cm2, in 27 patients affecting the medial femoral condyle and in six patients affecting the lateral femoral condyle. Trauma or osteochondrosis dissecans were pathogenetic in 82%.

Results: The Lysholm score in all 33 individuals showed a highly significant increase from a preoperative median 49.0 points to a median 86.0 points (P < or = 0.001). Twenty-seven patients returned to recreational sports. X-ray scans showed a rounding of the osteotomy edge in 24 patients, interpreted as a partial remodelling of the posterior femoral condyle. Preoperative osteoarthritis in 17 individuals was related to significant lower Lysholm scores (P = 0.014), but progression in 17 patients did not significantly influence the score results (P = 0.143). All 16 magnetic resonance imaging examinations showed vital and congruent grafts.

Conclusion: Patients significantly improve in the Lysholm score, in daily-life activity levels and in return to recreational sports. Thirty-one out of 33 patients were comfortable with the results and would undergo the procedure again. The MegaOATS technique is therefore recommended as a salvage procedure for young individuals with large osteochondral defects in the weight-bearing zone of the femoral condyle.

Show MeSH
Related in: MedlinePlus