Good medium-term functional results in reconstruction of lateral femoral condyle osteochondral lesions

Introduction: Results of autologous osteochondral graft (mosaicplasty) are well-reported for the medial femoral condyle but much less for the lateral femoral condyle. The main aim of the present study was to assess results specifically for lateral condyle reconstruction. The secondary objective was to compare results according to the two main etiologies: osteochondritis dissecans (OCD) and osteochondral fracture (OCF). Hypothesis: The study hypothesis was that medium-term functional and radiological results of lateral femoral condyle autologous osteochondral graft are good. Material and methods: A single-center retrospective continuous study included 24 patients with symptomatic focal lateral femoral condyle osteochondral lesion treated by osteochondral autograft, at a minimum 24 months' follow-up. Mosaicplasty was performed for lesions < 200 mm2, with associated fixation for lesions > 200 mm2 with viable osteochondral fragments. IKDC, Lysholm and KOOS functional scores and pain on visual analog scale (VAS) were collected at last follow-up. Progression toward osteoarthritis was assessed on comparative X-ray. Results: Twenty patients were analyzed (11 OCD, 9 OCF) at a mean of 66.4 +/- 44 months. Mean pain on VAS was 1.8 +/- 2 out of 10. Mean subjective IKDC, Lysholm and global KOOS scores were respectively 68.1 +/- 26, 76.5 +/- 22 and 73.9 +/- 21. Two patients showed Ahlback grade 2 lateral femorotibial osteoarthritis. Functional results were comparable between OCD and OCF. Conclusion: Reconstruction of lateral femoral condyle osteochondral lesion by osteochondral autograft gave good medium-term functional results, whatever the etiology. Longer-term studies are needed to assess progression toward osteoarthritis and functional deterioration over time. Level of evidence: IV; retrospective study.