Osteocondritis dissecans lesions of the knee restored by bone marrow aspirate concentrate. Clinical and imaging results in 18 patients

Eur J Orthop Surg Traumatol. 2023 May;33(4):857-867. doi: 10.1007/s00590-022-03214-1. Epub 2022 Feb 8.

Abstract

Background: Osteochondritis dissecans (OCD) is a common cartilage disorder that specifically affects the knees of skeletally immature and young adult patients. There have been a few treatments that have been proposed: fixation of the fragment, drilling, microfractures. The aim of this study was to analyze retrospectively clinical and imaging results obtained by treating it with one-step bone marrow-derived cells Transplantation (BMDCT) technique.

Methods: From 2007 to 2014, 18 patients (mean-age 19.1 ± 5.0 years) affected by OCD were treated with one-step BMDC transplantation. In our observational study, clinical evaluation was performed at a scheduled follow-up through IKDC, Tegner, KOOS and EQ-VAS. X-rays and MRI were conducted preoperatively and at 12 months. At final follow-up, MRI MOCART Score was evaluated.

Results: IKDC and KOOS clinical scores showed a progressive increase. Tegner Score at final follow-up (5.3 ± 2.7) was significantly lower compared to the pre-injury level (6.5 ± 2.1); however, these results showed a statistically significant improvement that remained over time. EQ-VAS showed a significant improvement in every follow-up measure. MRI Mocart Score showed a complete or almost complete filling of the lesion in 13 patients.

Conclusions: "One-step" technique allows articular surface restoration with viable physiologic osteochondral tissue with a high clinical efficacy and imaging results. The number of cases is still limited, and further studies with larger sample sizes and greater follow-up evaluations are required to confirm our results. Nevertheless, we believe that BMDCT may represent a suitable option to treat OCD lesion in young adults.

Keywords: Bone marrow-derived cell transplantation (BMDCT); Cartilage; Knee; Osteochondritis dissecans (OCD).

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Bone Marrow
  • Cartilage, Articular* / surgery
  • Follow-Up Studies
  • Humans
  • Knee
  • Knee Joint / surgery
  • Magnetic Resonance Imaging / methods
  • Osteochondritis Dissecans* / surgery
  • Retrospective Studies
  • Transplantation, Autologous
  • Treatment Outcome
  • Young Adult