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Mosaicplasty: a technical solution to cartilage grafts

Why perform a cartilage graft ?

MosaicplastyThe cartilage covering the bone, which ensures joint movement and mobility, is fragile. Damage can occur resulting in varying degrees of pain and discomfort. Unfortunately, the damaged cartilage is unable to regenerate itself.
If the damage is not too extensive, grafting can be used to reconstitute the cartilage. This operation helps prevent the lesion causing more serious damage to the cartilage and thus the development of osteoarthritis.

The mosaicplasty technique

Mosaicplasty is a recent knee cartilage graft technique which consists in harvesting small plugs of bone and cartilage from the less weight-bearing part of the joint so as not to have any impact.

The damaged area is prepared to receive the graft. A hole slightly smaller than the plug is created and the plugs are then inserted in this space. This procedure can be repeated several times to produce several grafts.

When should a mosaicplasty be performed ?

The first condition for performing a mosaicplasty concerns the size of the lesion, as a total cartilage graft is not possible. The damage must be a few cm2 at most and a graft can only be carried out if the damage is located in specific areas of the knee. In addition, the area around the graft must be in good condition.

Generally, this operation is recommended in young patients suffering from localised cartilage damage. This type of lesion generally appears following a trauma or osteochondritis dissecans.

It is also possible to envisage a mosaicplasty in the case of deep cartilage damage, if it is very localised.

Post-operation and results

A mosaicplasty requires 3 days in hospital.

The post-operative recovery period is quite long as no weight must be put on the knee whilst the grafts heal. Crutches are therefore necessary for 1 and a half months.

The short and medium term results of a mosaicplasty are good; the long term results have yet to be assessed as the technique is relatively new.