Mosaicplasty: a technical solution to cartilage grafts

Mosaicplasty: a technical solution to cartilage grafts

Why do a cartilage transplant?
The cartilage that covers the bones provides play and joint mobility. It is a fragile substance which can undergo lesions causing pain and discomfort to a greater or lesser extent. Unfortunately, damaged cartilage does not have the capacity to reform. When cartilage wear is not too extensive, it is now possible to restore it with the help of a transplant. Thanks to this operation, we manage to avoid the development of osteoarthritis, that is to say to stop the greater damage to the cartilage that this first lesion is likely to cause.

The aim of postural analysis is to determine how each individual works to enable the subject to reduce the excess strain.

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.

Dr Philippe Paillard

Article written by Dr Philippe Paillard

Specialist in orthopedic surgery and sports surgery, Dr. Philippe Paillard operates on patients with hip, knee, shoulder, elbow or ankle disorders or injuries.

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