Mosaicplasty (osteochondral autograft, cartilaginous bone graft transfer)
Widely known and accepted technique for focal chondral lesion and is often referred to as „mosaic” plasty (Hangody et al.), where small cylinders of the non weight bearing carilage surface is removed and transferred to the site of cartilage lesion.
Small and medium sized lesions might be treated by mosaicplasty. The main rational is that certain areas of the cartilage in the knee are non-weight bearing thus can be removed and transferred to the site of the lesion. As all cylinders consist of bony and cartilaginous part, the bony part would heal and fuse to the adjacent bony receiver site, and the cartilaginous cover of the joint will be smooth and intact after6-12 months. It has a major advantage to bone marrow stimulation as the histology of the repair site is hyaline cartilage rather than fibrocarilage. The drawback in this technique is that the cylinders must be removed from the intact joint and some donor site morbidity may occur. Furthermore the size of the non weight bearing area restricts the size of lesion that can be repaired.
Postoperatively strict rehab protocol is to be followed with physiotherapist’s supervision. Six weeks of partial weight bearing is recommended and the full recovery is expected about 6 months after the surgery.
Cartilage defect of the knee joint
Donor site after removal of grafts
Grafts ready to be implanted
. Mosaic plugs in place
