The role of primary stability in mosaicplasty: a review of the literature

Abstract

Mosaicplasty was introduced into clinical practice 15 years ago and since then it has gained increasing popularity in the treatment of small- and medium-sized cartilage defects. Survival of the transplanted cartilage and integration of the grafts have been shown both in animal studies and humans. Short- and mid-term results are now available and seem promising. Along with the widespread use of the technique, biomechanical investigations have been launched aiming at improvement of the operative technique and achieving better results. These studies are concerned with donor site morbidity, congruency, the effect of harvesting and implantation techniques, and primary stability. The latter is of paramount importance, since press-fit primary stability ensures that grafts remain flush with the surrounding cartilage surface, in which position integration occurs. A better understanding of the biomechanics of the mosaicplasty technique should improve the outcomes of the procedure. This paper summarizes the results of the biomechanical studies on primary stability in mosaicplasty and puts their conclusions into perspective.