Comparative analysis of long-term results of treatment of patients with osteochondral knee injuries (prospective, randomized study)

Objective: to evaluate the long-term results of treatment of athletes with osteo-chondral knee defects. Damage of the hyaline cartilage of the knee joint is quite common, and in 5-10% of cases requires surgical treatment. In the absence of proper treatment, such damage can lead to the osteoarthritis. According to some data in the structure of knee injuries of athletes contains about 36% cases of full-layer damage of hyaline cartilage. The most popular methods of treatment are microfracture and mosaic autochondroplasty. Materials and methods: the study was carried out from 2015 to 2018. We examined 56 patients with full-layer damage of hyaline cartilage of the knee joint, among them: 32-soccer players, 12-volleyball players, 7-kickboxers/ wrestlers, 5-field athletes. All patients were divided into 2 representative groups. The first group included 42 patients who underwent microfracturing, in the second group involved 14 patients with mosaic autochondroplasty. KOOS and Lysholm Knee Scoring Scale used to evaluate the results. The results statistically processed using the Mann-Whitney U-test. The level of evidence defined as p≤0.05. Results: the average follow-up period was 2.3 years (from 1.5 to 2.8 years). Comparing the results obtained in both groups, we registered a prevailing of mosaic autochondroplasty per 1.5 points by the Lysholm Knee scale (95% confidence interval) and 2.7 points by the Knee injury and osteoarthritis outcome scale (95% confidence interval). Conclusions: long-term results of treatment of patients with osteo-chondral injuries of the knee joint showed no significant difference between microfracturing and mosaic autochondroplasty. In both groups, a high level of functional state of knee joint was obtained on the scales of Knee injury and osteoarthritis outcome and Lysholm Knee in comparison with preoperative evaluation. We believe that microfracturing is less aggressive and quite effective method of treatment of patients with osteo-chondral defects of large joints, especially at young age. However, it should be noted that the implementation of the mosaic autochondroplasty allows to get the best long-term results at the expense of a stable and full replacement of the defect.

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