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XV CONGRESSO NAZIONALE DELLA SOCIETÀ POLISPECIALISTICA DEI GIOVANI CHIRURGHI
Delcogliano A., Caporaso A., Menghi A., Rinonapoli G., Chiossi S.
Background. To evaluate multiple osteochondral autografts for the treatment of traumatic chondral lesions of the knee.
Methods. Twenty-four (19 male and 5 female) patients underwent multiple osteochondral transplantation from 1995 to1999, the age ranging from 19 and 47 years old. Osteochondral lesion was localized on the femoral condyle in 21 cases, on the patella in 1 case and on the femoral groove in other 2 cases. The size of the lesion varied from 1 cm2 to 3 cm2. In 7 cases a single osteochondral graft and in 14 multiple ostechondral grafts has been harvested from non weight bearing areas of the knee. All patients except four were operated by arthroscopy. Four patients underwent arthrotomy because of the location of the lesion. The patients were examined with a 1 and 3 month follow-up and yearly thereafter (average f.u. 2 years and 4 months). For the clinical evaluation we used the IKDC Subjective Knee Evaluation Form. Before surgery, and, thereafter, during the follow-up sessions, the circumference of the thigh 10 cm proximally to the superior apex of the patella was measured.
Results. The results were evaluated as satisfactory in 75% of the cases (18/24). Best results were obtained in isolated chondral lesions and in cases that requested a smaller number of grafts. All the patients had an excellent recovery of the ROM, while a 1.3 cm side to side difference of muscle trophism (thigh circumference) was present during the one year follow-up.
Conclusions. We report good results with multiple autologous osteochondral grafts. Multiple osteochondral grafts appears to be the ''Golden standard'', in the treatment of chondral lesions lesions between 1.5 and 3.5 cm2.
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