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Osteochondral Autograft and Mosaicplasty in the Football (Soccer) Athlete

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      Abstract

      Objective:To evaluate the clinical outcomes of mosaicplasty in the treatment of focal chondral and osteochondral defects of joints among elite football players.Methods:Case series; Level of evidence, 4. The results of mosaicplasty were prospectively evaluated with 1-year intervals with patient-reported outcome measures, radiographs, and sports participation.Results:Sixty-one patients who received mosaicplasty in the knee joint were followed from 2 to 17 years (average, 9.6 years). The International Cartilage Repair Society (ICRS) score showed 89% good and excellent results. Sixty-seven percent of all players returned to the same level of sport, with 89% of the elite players and 62% of the competitive players. The average time to return to competitions was 4.5 months (range, 3.5-6.1 months). Players who had better clinical outcomes were significantly younger and had smaller lesions. The results of the medial and lateral condyles were significantly better than those in the patella or trochlea. Concomitant adjuvant procedures improved clinical outcomes. Despite a higher rate of preoperative osteoarthritic changes, clinical outcomes demonstrated a success rate similar to that of less athletic patients.Conclusion:Autologous osteochondral mosaicplasty in competitive football players is a good alternative procedure to repair cartilage damage.

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      Most cited references 28

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      The etiology of chondromalacia patellae.

       E Outerbridge (1961)
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        Articular cartilage defects: study of 25,124 knee arthroscopies.

        This retrospective study aimed to provide data on the prevalence, epidemiology and etiology of the knee articular cartilage lesions and describe and estimate, on the ground of a large database, the number of patients who might benefit from cartilage repair surgery. The analysis of 25,124 knee arthroscopies performed from 1989 to 2004 was conducted. Information concerning cartilage lesion, associated articular lesions and performed procedure were collected. Cartilage lesions were classified in accordance with the Outerbridge classification. Chondral lesions were found in 60% of the patients. Documented cartilage lesions were classified as localized focal osteochondral or chondral lesion in 67%, osteoarthritis in 29%, osteochondritis dissecans in 2% and other types in 1%. Non-isolated cartilage lesions accounted for 70% and isolated lesions accounted for 30%. The patellar articular surface (36%) and the medial femoral condyle (34%) were the most frequent localization of the cartilage lesions. Grade II according to Outerbridge classification was the most frequent grade of the cartilage lesion (42%). The most common associated articular lesions were the medial meniscus tear (37%) and the injury of the anterior crucial ligament (36%). Articular cartilage lesions are a common pathology of the knee joint. The potential candidates for cartilage repair surgery, patients with one to three localized grade III and IV cartilage lesions, under the age of 40 were found in 7% and under the age of 50 years in 9% of all analysed patients. However, because these patients are a heterogeneous group and the natural history of cartilage lesions remains so far unknown, also the total number of patients in our study, who might benefit from cartilage repair, remains unknown precisely.
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          Knee osteoarthritis after meniscectomy: prevalence of radiographic changes after twenty-one years, compared with matched controls.

          To study the long-term outcome of surgical removal of a meniscus in the knee with regard to radiographic signs of osteoarthritis (OA). Of the 123 patients who underwent an open meniscectomy due to an isolated meniscus tear in 1973 at Lund University Hospital, 107 were followed up 21 years later by clinical examination and by review of knee radiographs obtained with weight bearing. Seventy-nine of the 107 patients were men, and the mean age of the total study group at examination was 55 years (range 35-77). Sixty-eight sex- and age-matched individuals with healthy knees served as controls. Mild radiographic changes were found in 76 (71%) of the knees, while more advanced changes, comparable with a Kellgren-Lawrence grade of 2 or higher, were seen in 51 (48%). The corresponding prevalence values in the control group were 12 (18%) and 5 (7%), respectively. The relative risk for the presence of the more advanced radiographic changes representing definite radiographic tibiofemoral OA was 14.0 (95% confidence interval 3.5-121.2), using age- and sex-matched pairs for comparison. No correlation with sex, localization to compartment, type of meniscus tear, or work load was found. Knee symptoms were reported twice as often in the study group as in the controls. Surgical removal of a meniscus following knee injury represents a significant risk factor for radiographic tibiofemoral OA, with a relative risk of 14.0 after 21 years.
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            Author and article information

            Affiliations
            [1 ]Department of Orthopedics, Uzsoki Hospital, FIFA Medical Centre of Excellence, Budapest, Hungary
            Author notes
            Gergely Pánics, Uzsoki Hospital, Department of Orthopedics, Uzsoki u. 29-41. 1143, Budapest, Hungary Email: gergelypanics@ 123456gmail.com
            Journal
            Cartilage
            Cartilage
            CAR
            spcar
            Cartilage
            SAGE Publications (Sage CA: Los Angeles, CA )
            1947-6035
            1947-6043
            January 2012
            January 2012
            : 3
            : 1 Suppl , Special Issue Articular Cartilage Injury in the Football (Soccer) Player
            : 25S-30S
            4297169
            10.1177/1947603511408286
            10.1177_1947603511408286
            (Editor), (Editor), (Editor), (Editor), (Editor),
            © The Author(s) 2012
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