Articular cartilage lesions in unstable knees

Objectives: The purpose of this retrospective analysis was to evaluate the management of chondral defects in knees with anterior cruciate ligament (ACL) disruption.

Methods: Twenty-seven patients (mean age 35 years; range, 20 to 48 years) were randomized to osteochondral autologous transplantation (OAT, n=14) or a microfracture (MF, n=13) procedure together with ACL reconstruction in the same session for symptomatic lesions of the articular cartilage in ACL-deficient knees. The mean follow-up period was 34 months (range 24 to 53 months) in the OAT group, and 49 months (range 24 to 97 months) in the MF group. Patients were evaluated using the Lysholm and IKDC 2000 (International Knee Documentation Committee) scores.

Results: Patients undergoing OAT had a mean IKDC 2000 score of 49.2 (range 30.1 to 64.7), and Lysholm score of 43.4 (range 33.2 to 58.9) preoperatively. At the end of follow- up, these scores increased to 93.3 (range 73 to 98) and 97.5 (range 38.7 to 100), respectively. In the MF group, the mean IKDC 2000 score increased from 53.6 (range 47.1 to 64.7) to 72.3 (range 62.8 to 94), and the mean Lysholm score increased from 48 (range 38.2 to 58.9) to 81.3 (range 72.7 to 100).

Conclusion: Treatment of chondral lesions should be added to ACL reconstruction in unstable knees secondary to ACL deficiency.