Effects of Mosaicplasty on Donor Sites in the Knee
In this article, researchers from Japan report on the effects of harvesting bone plugs from the knee to treat a problem in the elbow. The patients were all competitive athletes. They had an elbow condition called osteochondritis dissecans (OCD).
Young gymnasts and overhand athletes are at risk for this condition. Most of the patients in this study were baseball pitchers. Forceful and repeated actions strain the immature surface of the outer part of the elbow joint.
The bone under the joint surface weakens and becomes injured. This causes damage to the blood vessels going to the bone. A loss of blood flow to the elbow causes a small section of the bone to die and break off.
Successful treatment involves taking bone plugs from healthy bone and transplanting them to the damaged and dying area of bone. The procedure is called mosaicplasty.
But what is the effect of this procedure on the knee where the donor bone comes from? MRI findings and tests of knee function were used to find out.
In all cases, the athletes returned to their previous level of sports participation. There were no donor site problems. MRIs of the donor site showed the defect filled in with fibrous tissue. There was no edema of the bone marrow or other changes seen on MRIs at the donor site.
The authors conclude there is no harm harvesting bone from a less weight bearing area of the knee to use in the elbow for OCD. Symptoms, function, and healing of the donor site are not a problem at the end of 12 months. Long-term studies are still needed to see if degeneration or other problems occur later in the donor knee.
Norimasa Iwasaki, MD, PhD, et al. Donor Site Evaluation After Autologous Osteochondral Mosaicplasty for Cartilaginous Lesions of the Elbow Joint. In The American Journal of Sports Medicine. December 2007. Vol. 35. No. 12. Pp. 2096-2100.
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