Fresh bone marrow and periosteum transplantation for cartilage defects of the knee.

The aim of work was to analyze clinical effectiveness of fresh bone marrow and periosteum transplantation in the treatment of traumatic or degenerative cartilage defects. The 14 patients in this study had a mean age of 37 years. Bone marrow aspirated from the iliac crest was implanted under the periosteum sutured over the defect. Three, 6, and 12 months postoperatively, the patients were evaluated with the analogue pain scale, modified Cincinnati score, and IKDC questionnaires. All patients were evaluated with magnetic resonance imaging (MRI) at 3 and 12 months postoperatively. After 3 and 6 months significant improvement was observed in eight patients. After 12 months, 12 patients were classified as normal or nearly normal in the IKDC examination form, and two as abnormal. Mean IKDC Subjective Knee Score was 86.57. MRI findings revealed surfaces with correct contours and continuity, without changes in subchondral bone in all but one patient. There was a correlation between a large size of defect or an osteoarthritic nature of the changes and poor results.