Return to sports after autogenous osteochondral mosaicplasty of the femoral condyles: 25 cases at a mean follow-up of 9 years

AbstractIntroductionAutogenous osteochondral mosaicplasty is the most common cartilage restoration technique in standard clinical practice. The purpose of this study was to evaluate the return to sports 9 years after mosaicplasty of the femoral condyles.HypothesisThe long-term results of an osteochondral autograft show that patients can regain their pre-injury activity level.Material and methodsThis study is based on a series of 25 patients with a mean age of 28.9 years (range, 16–44 years) who had stage 3 or 4 chondral lesions of the femoral condyles (according to the ICRS or ICRS-OCD scores). The origin of the lesion was osteochondritis dissecans (13 knees), osteochondral fracture sequelae (ten knees), or aseptic osteonecrosis (two knees). The average size of the lesion was 2.11±0.9 cm2. Ten patients (40%) had an associated procedure during the osteochondral autograft. The patients were assessed clinically (IKDC and Lysholm-Tegner scores) and radiographically by a reviewer independent of the team of operators.ResultsAll patients were re-examined at a mean follow-up of 9 years (range, 6–15 years), with 84% satisfied or very satisfied with the procedure. The average IKDC was 74.5±18.5 points. The average Lysholm score was 87.3±11.6 points. The average Tegner score ranged from 6.35±1.53 points prior to surgery to 5.60±1.64 points after surgery (P=0.001). The average loss was 0.64 points for patients whose presurgery Tegner score was greater than or equal to 7 (P=0.019) and 0.3 points if lower than 7. The radiologic evaluation of 21 patients showed complete osteointegration of the grafts in 90% of cases.ConclusionThe results of the femoral condyle mosaic autografts are satisfactory, a mean of 9 years after surgery. The most active patients lowered their activity level while the more sedentary did not have to adapt their lifestyle.Level of evidenceLevel IV, retrospective study

Acides gras et cancérogenèse mammaire

International audienc

What is the role of a-linolenic acid for mammals?

This review examines the data pertaining to an important and often underrated EFA, &alpha;-linolenic acid (ALA). It examines its sources, metabolism, and biological effects in various population studies, in vitro, animal, and human intervention studies. The main role of ALA was assumed to be as a precursor to the longer-chain n-3 PUFA, EPA and DHA, and particularly for supplying DHA for neural tissue. This paper reveals that the major metabolic route of ALA metabolism is &beta;-oxidation. Furthermore, ALA accumulates in specific sites in the body of mammals (carcass, adipose, and skin), and only a small proportion of the fed ALA is converted to DHA. There is some evidence that ALA may be involved with skin and fur function. There is continuing debate regarding whether ALA has actions of its own in relation to the cardiovascular system and neural function. Cardiovascular disease and cancer are two of the major burdens of disease in the 21st century, and emerging evidence suggests that diets containing ALA are associated with reductions in total deaths and sudden cardiac death. There may be aspects of the action and, more importantly, the metabolism of ALA that need to be elucidated, and these will help us understand the biological effects of this compound better. Additionally, we must not forget that ALA is part of the whole diet and should be seen in this context, not in isolation.<br /