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Table 3 Mosaicplasty surgical procedure characteristics and outcomes

From: Knee donor-site morbidity after mosaicplasty – a systematic review

First author (year) Donor site Plugs size (mm) No. plugs (range) Time to surgery (months) No. of previous surgeries No. concomitant procedures Follow-up (months) Radiological outcomes Satisfaction (%) Return to sports activity (%) Second-look arthroscopy (%) Complications
Knee
 Atik et al. (2005) Minimal weightbearing area of the patellofemoral joint or the intercondylar notch area 3.5 ≤5 N.R. N.R. N.R. 48 Normal shiny appearance and color of the grafted area (100 %)a N.R. N.R. 42 Slight joint effusion (n = 12).
 Espregueira-Mendes et al. (2012) Upper tibio-fibular joint N.R. 2.5 (1-6) N.R. N.R. N.R. 110.1 MRI-scoring system: good (26 %), fair (65 %) and poor (10 %)d 90 N.R. N.R. N.R.
 Gudas et al. (2005) Lateral/medial margin of the femoral trochlea 5.5 4.3 (3-6) 21.3 0 N.R. 37.1 ICRS: 27 (96 %) good to excellent results.cd N.R. 93 50 Superficial infection (n = 2).
 Hangody et al. (2008) Margin of the medial and lateral femoral condyle superior to the sulcus terminalis and notch area (for larger defects) N.R. N.R. N.R. N.R. 783 At least 12 N.R. N.R. N.R. 10 Deep infections (n = 4), painful haemarthroses (n = 56), minor thromboembolic complications (n = 4).
 Hangody et al. (2010) Margin of the medial and lateral femoral condyle superior to the sulcus terminalis 4.5-8.5 2.7 (1-9) N.R. N.R. 225 115.2 Fairbank: grades I-II in 19 % and grades II-III in 8%c 90 91 7 Septic arthritis (n = 2), intra-articular hemorage (n = 2).
 Jakob et al. (2002) Medial and the lateral edging of the femoral trochlea and notch area (for larger defects) 6.3 6 (1-16) N.R. 3 47 37 ICRS: nearly normal (grade II) in 91%d Demarcating border (<1 mm) between the grafted surface and the surrounding cartilaged Smooth or slightly fibrillated surface of autograftsd 88 52 24 Reflex sympathetic dystrophy (n = 1), graft failure (n = 4), severe infection (n = 1) and postoperative joint stiffness (n = 1).
 Kock et al. (2010) Trochlear border of the lateral femoral condyle 9.4 2.4 (1–4) N.R. N.R. N.R. 49 Did not performed radiological evaluation N.R. N.R. N.R. N.R.
 Koulalis et al. (2004) Lateral femoral condyle 2.9 2.9 (1–7) N.R. N.R. 3 27.2 ICRS: normal (67 %) and nearly normal (33 %)d Cartilaginous coverage of the defect (100 %)d Osseous integration of the grafts (100 %)d N.R. N.R. 22 N.R.
 Quarch et al. (2014) Dorsal medial femoral condyle 8.5 3.8 N.R. N.R. N.R. 13.8 Henderson score (modified): 11.1 pointsd N.R. N.R. N.R. Bone marrow edema with osseous cysts (n = 1).
 Reverte-Vinaixa et al. (2013) Lateral edge of the trochlea 9.3 2.8 (1-7) N.R. 12 N.R. 12 Surface congruency and correct graft integration with no signs of fissuring or delamination (88 %)d N.R. N.R. N.R. Necrosis and cystic degeneration of the grafts (n = 2) and persistent graft oedema (n = 5).
 Clavé et al. (2016) Trochlear facets/groove and intercondylar notch 8.6 1.6 (1-4) 66.1 13 N.R. 24 N.R. N.R. N.R. N.R. Intra-articular effusion (n = 2); hematoma (n = 1); popliteal cyst (n = 1).
Ankle
 Ahmad and Jones (2015) Extra-articular superolateral distal femoral condyle N.R. N.R. N.R. N.R. N.R. 35.2 Full osteochondral healing (90 %)c N.R. N.R. N.R. Post-operative superficial wound blistering (n = 1) and non-union graft (n = 2).
 Al-Shaikh et al. (2002) Trochlear border of the lateral femoral condyle 8.6 1.3 (1-2) 50.4 13 1 16 No evidence of graft subsidence and all grafts healed (100 %)c 83 N.R. N.R. Neuroma (n = 2); superficial wound slough (n = 1); symptomatic hardware (n = 1).
 Baltzer and Arnold (2005) Superolateral condyle of the ipsilateral knee N.R. 1.8 (1-4) >9 N.R. N.R. Up to 54 Bone integration into the taluscd 95 Most of included participants At least 58 N.R.
 Gautier et al. (2002) Non-weight-bearing trochlear border of the ipsilateral knee 6.4 4.4 (1-6) N.R. N.R. N.R. 24 Incorporation of the graft and intergraft intergration (91 %)e 91 100 27 Partial resorption of graft (n = 1)
 Hangody et al. (2001a), (2001b) Minimal weightbearing areas of the femoral condyles at the level of the patellofemoral joint 4.5-6.5 (n = 27) 3.5 (n = 9) 3 (1-6) 9 29 N.R. 50.4 Good incorporation of all the transplanted graftsc N.R. N.R. 22 None
 Kim et al. (2012) Lateral edge of the lateral trochlea 9.3 1.4 (1-2) 20.4 10 14 34.1 Congruent graft margins (88 %)a 95 N.R. 100 Adhesion (n = 15); synovitis (n = 16); incongruent surface of the graft (n = 10); uncovered area (n = 14).
 Lee et al. (2003) Superomedial margin (nonweightbearing area) of the medial femoral condyle of the ipsilateral knee 6-7 2.2 (2-4) 12.2 N.R. N.R. 36 Consistency of articular surface of the grafts and congruity between the native cartilage (88 %)a N.R. 76 94 N.R.
 de l'Escalopier et al. (2015) Medial (n = 15) and lateral (n = 22) edge of the trochlea 5.7 2.3 (1-8) 29 8 8 76 Joint space narrowing (16 %) N.R. N.R. N.R. None
 Reddy et al. (2007) Intercondylar notch or the lateral femoral condyle proximal to the sulcus terminale 5.0 2.9 (2-4) N.R. N.R. N.R. 47 N.R. 82 N.R. N.R. N.R.
 Valderrabano et al. (2009) Lateral femoral condyle N.R. 3 (2-6) N.R. >9 N.R. 72 Partially narrowed cartilage (100 %), no joint space narrowing (67 %) and subchondral bone plate was partially disrupted (58 %) or missing (25 %)bd 92 50 N.R. Cyst formation (n = 11); bone bruising (n = 9); loose bodies (n = 5). b
  1. Legends: ICRS International Cartilage Repair Society score, N.R. Not reported, MRI Magnetic resonance imaging. Footnotes: aResults reported through second-look arthroscopy; bReport of the 12 included patients on the follow-up, from a cohort of 21 patients; c Results reported through radiography; d Results reported through MRI; e Results reported through CT