Fresh Osteochondral Allograft Transplantation for Fractures of the Knee. (April 2017)

• Record Type: Journal Article
• Authors: Gracitelli, Guilherme C.; Tirico, Luis Eduardo Passarelli; McCauley, Julie C.; Pulido, Pamela A.; Bugbee, William D.
• Is Part Of: Cartilage. Volume 8:Number 2(2017)
• Page Start: 155
• Page End: 161
• Publication Date: 2017-04
• Subjects: osteochondral allograft transplant -- knee fracture -- functional outcomes -- survivorship; Cartilage -- Periodicals; 616.7
• DOI: 10.1177/1947603516657640
• Languages: English
• ISSNs: 1947-6035

Abstract

Objective: The purpose of this study was to evaluate functional outcomes and allograft survivorship among patients with knee fracture who underwent fresh osteochondral allograft (OCA) transplantation as a salvage treatment option. Design: Retrospective analysis of prospectively collected data. Setting: Department of Orthopaedic Surgery at one hospital. Patients: Fresh OCAs were implanted for osteochondral lesions after knee fracture in 24 males and 15 females with an average age of 34 years. Twenty-nine lesions (74%) were tibial plateau fractures, 6 (15%) were femoral condyle fractures, and 4 (10%) were patella fractures. Main Outcome Measurements: Clinical evaluation included modified Merle d'Aubigné-Postel (18-point), International Knee Documentation Committee, and Knee Society function scores, and patient satisfaction. Failure of OCA was defined as revision OCA or conversion to total knee arthroplasty (TKA). Results: Nineteen of 39 knees (49%) had further surgery. Ten knees (26%) were considered OCA failures (3 OCA revisions, 6 TKA, and 1 patellectomy). Survivorship of the OCA was 82.6% at 5 years and 69.6% at 10 years. Among the 29 knees (74%) that had the OCA still in situ, median follow-up was 6.6 years. Pain and function improved from preoperative to latest follow-up; 83% of patients reported satisfaction with OCA results. Conclusion: OCA transplantation is a useful salvage treatment option for osteochondral lesions caused by knee fracture. Although the reoperation rate was high, successful outcome was associated with significant clinical improvement.