Osteochondral autologous transplantation for the treatment of full-thickness cartilage defects of the shoulder : RESULTS AT NINE YEARS

• Published in: Journal of bone and joint surgery. British volume Vol. 91; no. 4; pp. 499 - 503
• Main Authors: KIRCHER, J, PATZER, T, MAGOSCH, P, LICHTENBERG, S, HABERMEYER, P
• Format: Journal Article
• Language: English
• Published: London British Editorial Society of Bone and Joint Surgery 01.04.2009; British Editorial Society of Bone & Joint Surgery
• Edition: British volume
• Subjects: Adult; Biological and medical sciences; Bone Transplantation - methods; Cartilage, Articular - injuries; Cartilage, Articular - transplantation; Diseases of the osteoarticular system; Female; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Orthopedic surgery; Osteoarthritis - diagnostic imaging; Osteoarthritis - etiology; Radiography; Severity of Illness Index; Shoulder Joint - diagnostic imaging; Shoulder Joint - injuries; Shoulder Joint - pathology; Shoulder Joint - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Treatment Outcome; Young Adult; Cartilage; Graft; Autograft; Orthopedic surgery; Treatment; Shoulder
• ISSN: 0301-620X; 2049-4394; 2044-5377; 2049-4408
• DOI: 10.1302/0301-620X.91B4.21838

We describe the outcome at a mean follow-up of 8.75 years (7.6 to 9.8) of seven patients who had undergone osteochondral autologous transplantation for full-thickness cartilage defects of the shoulder between 1998 and 2000. These patients have been described previously at a mean of 32.6 months when eight were included. One patient has been lost to follow-up. The outcome was assessed by the Constant shoulder score and the Lysholm knee score to assess any donor-site morbidity. Standard radiographs and MR scores were obtained and compared with the pre-operative findings and the results from the previous review. No patient required any further surgery on the shoulder. The mean Constant score improved significantly until the final follow-up (p = 0.018). The Lysholm score remained excellent throughout. There was a significant progression of osteoarthritic changes from the initial surgery to the first and final follow-up but this did not appear to be related to the size of the defect, the number of cylinders required or the Constant score (p = 0.016). MRI showed that all except one patient had a congruent joint surface at the defect with full bony integration of all osteochondral cylinders. The results have remained satisfactory over a longer period with very good objective and subjective findings.