Geoffrey D Abrams1, Kristen E Hussey2, Joshua D Harris2, Brian J Cole2. 1. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.. Electronic address: gabrams@gmail.com. 2. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
Abstract
PURPOSE: To determine clinical results after combined femoral osteochondral allograft and meniscus transplantation. METHODS: Thirty-two patients with a minimum 2-year follow-up were identified who had previously undergone combined meniscus allograft transplantation and fresh osteochondral allograft transplantation. Demographic and intraoperative data, including condylar defect size, as well as the preoperative and postoperative International Knee Documentation Committee (IKDC) score, Short Form 12 score, Knee Injury and Osteoarthritis Outcome Score (KOOS), and Lysholm score, were recorded. Paired tests and regression analysis were used, and an α value of .05 was set as significant with Bonferroni correction used in the case of multiple comparisons. RESULTS: The mean follow-up period was 4.2 years (range, 2 to 11 years). The mean condylar defect size was 4.7 ± 2.0 cm2 at the time of the index procedure. Lysholm scores, IKDC scores, and all KOOS subdomains showed significant improvement from preoperatively to postoperatively (P < .001). Patients with condylar defects of less than 4 cm2 had a significantly greater increase in the preoperative versus postoperative IKDC score (P = .010), Lysholm score (P = .018), and KOOS (P = .016) than those with condylar defects greater than 4 cm2. Femoral condyle defect size was also significantly inversely correlated with the postoperative IKDC score (P = .015), KOOS (P = .003), and Lysholm score (P = .010). The rate of patient satisfaction with the procedure was 82%. CONCLUSIONS: Patients undergoing combined meniscus allograft and femoral osteochondral allograft transplantation showed improved functional scores after surgery. The postoperative scores, however, indicated residual knee dysfunction, and the reoperation rate was high. There was an inverse association between postoperative functional scores and the size of the condylar defect. LEVEL OF EVIDENCE: Level IV, therapeutic case series.
PURPOSE: To determine clinical results after combined femoral osteochondral allograft and meniscus transplantation. METHODS: Thirty-two patients with a minimum 2-year follow-up were identified who had previously undergone combined meniscus allograft transplantation and fresh osteochondral allograft transplantation. Demographic and intraoperative data, including condylar defect size, as well as the preoperative and postoperative International Knee Documentation Committee (IKDC) score, Short Form 12 score, Knee Injury and Osteoarthritis Outcome Score (KOOS), and Lysholm score, were recorded. Paired tests and regression analysis were used, and an α value of .05 was set as significant with Bonferroni correction used in the case of multiple comparisons. RESULTS: The mean follow-up period was 4.2 years (range, 2 to 11 years). The mean condylar defect size was 4.7 ± 2.0 cm2 at the time of the index procedure. Lysholm scores, IKDC scores, and all KOOS subdomains showed significant improvement from preoperatively to postoperatively (P < .001). Patients with condylar defects of less than 4 cm2 had a significantly greater increase in the preoperative versus postoperative IKDC score (P = .010), Lysholm score (P = .018), and KOOS (P = .016) than those with condylar defects greater than 4 cm2. Femoral condyle defect size was also significantly inversely correlated with the postoperative IKDC score (P = .015), KOOS (P = .003), and Lysholm score (P = .010). The rate of patient satisfaction with the procedure was 82%. CONCLUSIONS:Patients undergoing combined meniscus allograft and femoral osteochondral allograft transplantation showed improved functional scores after surgery. The postoperative scores, however, indicated residual knee dysfunction, and the reoperation rate was high. There was an inverse association between postoperative functional scores and the size of the condylar defect. LEVEL OF EVIDENCE: Level IV, therapeutic case series.