Purpose: To prospectively assess clinical outcomes and regeneration of osteoarthritic cartilage
lesions treated with an articular cartilage paste grafting technique. Type of Study: Prospective, longitudinal case series. Methods: We treated 125 patients (136 procedures; 34% female, 66% male; mean age, 46 years;
range, 17 to 73 years) with an Outerbridge classification of grade IV lesions with
an articular cartilage paste graft. Clinical data were recorded 2 to 12 years from
surgery, with 20 of 145 patients lost to follow-up over 12 years (13.7%). Clinical
outcomes were captured annually with validated Western Ontario and McMaster Universities
Arthritis Index (WOMAC), International Knee Documentation Committee (IKDC), and Tegner
subjective questionnaires. Regenerated cartilage biopsy specimens were obtained at
second-look arthroscopy from 66 patients and evaluated as to quality and quantity
of defect fill by a blinded, independent histopathology reviewer. Results: Preoperative versus postoperative validated pain, functioning, and activity measures
improved significantly (P< .001). Clinically, 18 of the 125 patients were considered failures (14.4%), with
10 patients undergoing subsequent joint arthroplasty and 8 who reported worse pain
after surgery. Regional histologic variation occurred. Forty-two of 66 biopsy specimens
(63.6%) showed strong and consistent evidence of replacement of their articular surface,
and 18 of 66 biopsy specimens (27.3%) showed development of areas of cartilage. Conclusions: Paste grafting is a low-cost, 1-stage arthroscopic treatment for patients with Outerbridge
classification grade IV arthritic chondral lesions. The procedure offers excellent,
long-lasting, pain relief, restored functioning, and possibility of tissue regeneration
for patients with painful chondral lesions in both arthritic and traumatically injured
knees. Level of Evidence: Level IV, case series.
Key Words
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- ErratumArthroscopyVol. 22Issue 4
- PreviewIn the article “Articular Cartilage Paste Grafting to Full-Thickness Articular Cartilage Knee Joint Lesions: A 2- to 12-Year Follow-up” published in the March 2006 issue of Arthroscopy (2006;22:291-299), the average area grafted value reported in Methods, Chondral Lesions, third sentence, on page 292, contains a decimal error. The sentence should read:
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