@article {18875, title = {Knee donor-site morbidity in mosaicplasty - A systematic review}, journal = {Journal of Experimental Orthopaedics}, year = {2016}, month = {2016-10-24 00:00:00}, abstract = {

Background: Mosaicplasty has been associated with good short- to long-term results. Nevertheless, the osteochondral harvesting is restricted to the donor-site area available and it may lead to significant donor-site morbidity.

Purpose: Provide an overview of donor-site morbidity associated with harvesting of osteochondral plugs from the knee joint in mosaicplasty procedure.

Methods: Comprehensive search using Pubmed, Cochrane Library, SPORTDiscus and CINAHL databases was carried out through 10th October of 2016. As inclusion criteria, all English-language studies that assessed the knee donor- site morbidity after mosaicplasty were accepted. The outcomes were the description and rate of knee donor-site morbidity, sample{\textquoteright}s and cartilage defect{\textquoteright}s characterization and mosaicplasty-related features. Correlation between mosaicplasty features and rate of morbidity was performed. The methodological and reporting quality were assessed according to Coleman{\textquoteright}s methodology score.

Results: Twenty-one studies were included, comprising a total of 1726 patients, with 1473 and 268 knee and ankle cartilage defects were included. The defect size ranged from 0.85 cm2 to 4.9 cm2 and most commonly 3 or less plugs (averaging 2.9 to 9.4 mm) were used. Donor-site for osteochondral harvesting included margins of the femoral trochlea (condyles), intercondylar notch, patellofemoral joint and upper tibio-fibular joint. Mean donor-site morbidity was 5.9 \% and 19.6 \% for knee and ankle mosaicplasty procedures, respectively. Concerning knee-to-knee mosaicplasty procedures, the most common donor-site morbidity complaints were patellofemoral disturbances

(22 \%) and crepitation (31 \%), and in knee-to-ankle procedures there was a clear tendency for pain or instability during daily living or sports activities (44 \%), followed by patellofemoral disturbances, knee stiffness and persistent pain (13 \% each). There was no significant correlation between rate of donor-site morbidity and size of the defect, number and size of the plugs (p \> 0.05).

Conclusions: Osteochondral harvesting in mosaicplasty often results in considerable donor-site morbidity. The donor-site morbidity for knee-to-ankle (16.9 \%) was greater than knee-to-knee (5.9 \%) mosaicplasty procedures, without any significant correlation between rate of donor-site morbidity and size of the defect, number and size of the plugs. Lack or imcomplete of donor-site morbidity reporting within the mosaicplasty studies is a concern that should be addressed in future studies.

}, keywords = {Mosaicplasty, Systematic review}, issn = {2197-1153}, doi = {10.1186/s40634-016-0066-0}, author = {Andrade, R. and Vasta, S. and Pereira, R. and Pereira, H. and Papalia, R. and Karahan, M. and Oliveira, J. M. and Reis, R. L. and Espregueira-Mendes, J.} }