Osteoarticular grafts in the treatment of OCD of the talus: mosaicplasty versus autologous chondrocyte transplantation

Further advancements in articular cartilage transplantation require an understanding of the anatomy, physiology, biomaterials, biology, and cartilage engineering that are fundamental for better results in joint arthroplasty and cartilage repair. Currently, efforts to induce healing and regeneration of cartilage are being directed toward enhancing the natural potential of cartilage to replace the damaged tissue with cells that can generate cartilage. Mosaicplasty and ACT are carried out in the same way, have similar therapeutic indications, and have been demonstrated capable of reconstructing hyaline cartilage with similar clinical results. ACT is the most recent technique and, in the authors' opinion, is preferable in that it is less invasive at the donor site and gives better histologic results because of the reconstruction of a continuous cartilage sheath compared with that achieved by mosaicplasty. Furthermore, with this technique, it is possible to forecast the possibility of improvement owing to further technical and biologic advancements. The authors are currently experimenting with the use of adhesive patches with substitution of the periosteum, resulting in less morbidity. The use of growth factors and new tissue engineering techniques in the future would simplify the methodology, rendering it less invasive and more effective.