Arthroscopic Retrograde Osteochondral Autograft Transplantation for Cartilage Lesions of the Tibial Plateau

Abstract

Background: There are only 2 reported cases of arthroscopic retrograde osteochondral autograft transplantations regarding tibial plateau cartilage defects. Purpose: To present a detailed description of arthroscopic retrograde osteochondral autograft transplantation of the tibial plateau as well as to provide its advantages and disadvantages in comparison with other techniques. Study Design: Case series; Level of evidence, 4. Methods: Four patients (3 men and 1 woman; mean age, 31.2 years) suffering from tibial plateau cartilage lesions underwent surgery. In each case, the lesions were caused by sports injuries. There were 3 lateral and 1 medial tibial plateau defects. The International Knee Documentation Committee (IKDC) score and Knee injury and Osteoarthritis Outcome Score (KOOS) were recorded preoperatively and postoperatively. Radiological assessment was made by plain radiographs, CT arthroscans, and MRI. Results: The mean follow-up was 55 months (range, 52-60). The mean preoperative IKDC score was 53.5 (range, 37-66), while the mean postoperative IKDC score at final follow-up was 95.4 (range, 93.1-97.7). Regarding the KOOS calculation, there was significant improvement concerning each parameter after surgery. All patients were satisfied with the surgical procedure and returned to their previous activity level. Postoperative imaging showed very good adaptation and incorporation of the osteochondral autografts. Conclusion: Treatment of tibial plateau cartilage defects with arthroscopic retrograde osteochondral autograft transplantation could be performed on a routine basis in clinical practice. The results were encouraging and showed good incorporation of the graft, a minimal failure rate, and satisfactory functional outcomes of patients.