Prospective Evaluation of Prolonged Fresh Osteochondral Allograft Transplantation of the Femoral Condyle: Minimum 2-Year Follow-Up

Background Focal articular cartilage lesions of the knee in young patients present a therapeutic challenge. Little information is available pertaining to the results after implantation of prolonged fresh grafts. Hypothesis Prolonged fresh osteochondral allografts present a viable option for treating...

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Bibliographic Details
Published in:The American journal of sports medicine 2007-03, Vol.35 (3), p.411-420
Main Authors: McCulloch, Patrick C., Kang, Richard W., Sobhy, Mohamed H., Hayden, Jennifer K., Cole, Brian J.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Biological and medical sciences
Care and treatment
Egypt
Female
Femur
Follow-Up Studies
Fundamental and applied biological sciences. Psychology
Humans
Male
Medical sciences
Middle Aged
Osteoarthritis, Knee - surgery
Osteochondritis
Osteochondrosis
Outcome Assessment (Health Care) - methods
Prospective Studies
Sport (general aspects)
Transplantation, Homologous
Traumas. Diseases due to physical agents
Vertebrates: body movement. Posture. Locomotion. Flight. Swimming. Physical exercise. Rest. Sports
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Summary:Background Focal articular cartilage lesions of the knee in young patients present a therapeutic challenge. Little information is available pertaining to the results after implantation of prolonged fresh grafts. Hypothesis Prolonged fresh osteochondral allografts present a viable option for treating large full-thickness articular cartilage lesions. Study Design Case series; Level of evidence, 4. Methods This study presents the results of 25 consecutive patients who underwent prolonged fresh osteochondral allograft transplantation for defects in the femoral condyle. The average patient age was 35 years (range, 17-49 years). The average length of follow-up was 35 months (range, 24-67 months). Prospective data were collected using several subjective scoring systems, as well as objective and radiographic assessments. Results Statistically significant improvements (P < .05) were seen for the Lysholm (39 to 67), International Knee Documentation Committee scores (29 to 58), all 5 components of the Knee injury and Osteoarthritis Outcome Score (Pain, 43 to 73; Other Disease-Specific Symptoms, 46 to 64; Activities of Daily Living Function, 56 to 83; Sport and Recreation Function, 18 to 46; Knee-Related Quality of Life, 22 to 50), and the Short Form-12 physical component score (36 to 40). Overall, patients reported 84% (range, 25% to 100%) satisfaction with their results and believed that the knee functioned at 79% (range, 35% to 100%) of their unaffected knee. Radiographically, 22 of the grafts (88%) were incorporated into host bone. Conclusion Fresh osteochondral allograft transplantation is an acceptable intermediate procedure for treatment of localized osteochondral defects of the femur. At 2-year follow-up, it is well incorporated and offered consistent improvements in pain and function. Clinical Relevance Prolonged fresh allograft transplantation is a safe and effective technique for addressing symptomatic osteoarticular lesions in the knees of young patients.
ISSN:0363-5465
1552-3365
DOI:10.1177/0363546506295178