• Mika Frieda Rollmann, Steven Christian Herath, Tina Histing, Benedikt Johannes Braun, Julia Schmalenbach, Yvette Draenert, Klaus Draenert, and Tim Pohlemann.
• Department of Trauma, Hand and Reconstructive Surgery, Saarland University, 66421, Homburg, Saar, Germany. mika.rollmann@uks.eu.
• Eur J Trauma Emerg Surg. 2021 Oct 1; 47 (5): 1627-1634.

PurposeThe surgical diamond instrumentation (SDI), a precise wet-grinding technology, promised contact healing of press-fit inserted bone and even hyaline cartilage, lacks medium- and long-term results. This retrospective study was conducted to identify risk factors associated with the failure of the technique and the subjective patient outcome.MethodsAll patients treated for cartilage defects of the knee or ankle joint using the SDI technology between 2000 and 2012 with a follow-up > 1 year were included. Patients with general joint diseases or joint-related procedures, except for corrective osteotomies, were excluded. A standardized questionnaire (EQ-5D) and a questionnaire-based patient-reported outcome survey were used. Descriptive statistics were applied. A multivariate analysis examining risk factors for joint failure was performed. A p value < 0.05 was considered to indicate significant differences.Results87 patients with autologous osteochondral transplantation (68 knee, 19 ankle) were included. The median age was 53 years (IQR 37.5-63.0 years) for knee and 36 years (IQR 27.5-54.0 years) for ankle joints. 57.9% of knee and 55.6% of ankle patients were female. Nine patients (8 knee, 1 ankle) had received arthroplasty. 93.3% of knee and 83.3% of ankle patients had an excellent function or minor disabilities. 73.3% of knee and 64.7% of ankle patients did not require pain medication. The mean EQ-5D score was 0.84 for knee and 0.77 for ankle. Patients with higher age were more likely to receive arthroplasty (p = 0.022).ConclusionsThe SDI technique provides promising results with excellent joint survival rates and satisfying patient-reported outcomes. Failure of the technique might be associated with higher age.© 2020. Springer-Verlag GmbH Germany, part of Springer Nature.

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