Tarek Aly and Waleed Ewais
Aim: Articular cartilage defects in the knee do not heal and may dispose a predisposition for an early onset of osteoarthritis. Large osteochondral defects are associated with mechanical instability and are accepted indications for surgical intervention to prevent development of degenerative joint disease. Purpose: The purpose of this study to evaluate the effect of drilling on treatment of knee osteochondral defects among 2-3 cm².
Methods: Twenty six patients (18 men and 8 women) with focal full-thickness cartilage lesions of the knee on the medial or lateral femoral condyle, or trochlea were included in this study. The surgical technique is through arthroscopic subchondral drilling. Lysholm score was used for evaluation of outcome. Clinical evaluation and scoring were done preoperatively and at follow-up.
Results: Lysholm score was 43.0 ± 12 preoperatively, improved to 88.0 ± 9 postoperatively. Radiologically, complete healing of the defect was observed in all cases except 2.
Conclusion: Subchondral drilling can be an effective approach for the treatment of osteochondral defects sized 2-3 cm². Using this method, most of the patients with failed non-operative treatment successfully can postpone the joint arthroplasty after a single joint preserving surgical procedure.