[Repair of focal chondral lesions of femoral condyles treated with osteochondral autografts].

A series of 15 patients with focal chondral lesions of the femoral condyles were treated at the Orthopaedics Department of the University of Medical Sciences of Lublin between 1998-2000. The patients' age varied from 20 to 72 years and the follow-up period from 6 months to 2.5 years. Osteochondritis dissecans was observed in 9 patients. Articular cartilage defects associated with chronic ligament instability was noted in 5 cases and 1 patient suffered from a chondral fracture of the lateral femoral condyle during a traumatic luxation of the patella. The depth of the lesions was graded according to ICRS scale. Grade IV was found in 11 cases and the remaining 4 cases had grade III lesions. The defects were treated with osteochondral autografts using OATS instrumentation set. Results were prospectively evaluated according to the HSS score. The preoperative value of HSS score ranged from 28 to 51 points (average 40.3). During follow-up the score values ranged from 76 to 91 points (average 84.7 points). All patients regained full range of motion in the knee, although in one case arthroscopic release of intraarticular adhesions was performed 6 months after chondroplasty. The lowest HSS values at follow-up were found in elderly patients with concomitant mild degenerative changes in the lateral knee compartment and in the patello-femoral joint. All patients had MRI examination early post-op, then after 6, 12 and 24 months from the procedure. MRI confirmed proper structure of the grafted cartilage but bony parts of the graft did not integrate with the surroundings.