Purpose

The purpose of the study was to compare the arthroscopic and radiologic results of combined osteochondral autograft transfer(OAT) and microfracture(MF) Technique, and microfracture only technique

Methods and Materials

One-hundred twenty-five knees in 120 patients who have undergone cartilage repair procedures for the treatment of osteoarthritis of medial compartment of the knee were retrospectively reviewed and divided into two groups ; Group 1 included 63 knees in 60 patients who were treated with HTO and combined OAT and MF technique, and Group 2 62 knees in 60 patients who were treated with HTO and MF only technique.

We compared Kellgren-Lawrence(K-L) Grading and regenerated cartilage status evaluated by second-look arthroscopy around 1 year postoperatively , including ICRS grading, defect coverage, protrusion, consistency, smoothness, and marginal integration, between both groups. All the parameters were compared according to the postoperative anatomical axis, bifocal repair, and HTO methods. Statistical analysis was conducted with student t test, and ANOVA test.

Results

Average age and follow-up period of Group 1 and Group 2 were 53 years and 55.2 years, 14.7 months and 13.3 months, respectively.

Group 1 showed better results in cartilage repair of MFC and MTP lesion than Group 2 on second-look arthroscopic evaluation ( ICRS grade 1 and 2 for MFC, 83.4 % vs 62.5%, P<0.005 ; for MTP, 59.6 % vs 47.4%, P=0.019) ). On subcategory evaluation of cartilage repair, Group 1 also revealed better results in terms of defect coverage and consistency of MFC cartilage repair . In radiologic evaluation with K-L grading, Group 1 showed significantly more severe arthritic change than Group 2 preoperatively, but no significant difference between the groups postoperatively .

Conclusion

Combined OAT and MF technique seems to show better cartilage repair than MF only technique. However, long-term follow-up study will be needed to confirm the effectiveness of combined OAT and MF technique.