Editors Choice Paper Award 2016

Winner of the KSSTA Best Paper Award 2014-2016

Microfracture technique versus osteochondral autologous transplantation mosaicplasty in patients with articular chondral lesions of the knee: a prospective randomized trial with long-term follow-up


Svend Ulstein, Asbjørn Arøen, Jan Harald Røtterud, Sverre Løken, Lars Engebretsen and Stig Heir

Despite considerable research efforts and advances in surgical techniques, chondral and osteochondral lesions remain a challenge for the orthopaedic surgeon. None of the surgical strategies, ranging from debridement to advanced cell-based treatment, is established as the “golden standard“.

Osteochondral autologous transplantation (mosaicplasty) and the microfracture technique have both shown promising result at short- to midterm follow-up. However, high quality studies of long-term results have been sparse.

In this prospective randomized trial our aim was to compare the long-term results after osteochondral autologous transplantation and microfracture. As in many knee cartilage surgery studies, inclusion of patients was challenging. Even though the duration of the inclusion period was extended up to five years, only 25 patients were included. However, a follow-up of 100% for the main outcome (Lysholm score) was accomplished. Moreover, a broad spectrum of outcome measures (KOOS, isokinetic muscle strength, reoperations/failures and radiographic OA evaluation) were assessed and compared between the two groups.

We believe that the result from the current study provides some important knowledge regarding the long-term outcome following these two “old”, but still relevant surgical techniques. Enjoy!

Svend Ulstein