Literature DB >> 29314864

Outcomes of Osteochondral Allograft Transplantation With and Without Concomitant Meniscus Allograft Transplantation: A Comparative Matched Group Analysis.

Rachel M Frank1, Simon Lee2, Eric J Cotter2, Charles P Hannon2, Timothy Leroux2, Brian J Cole2.   

Abstract

BACKGROUND: Osteochondral allograft transplantation (OCA) is often performed with concomitant meniscus allograft transplantation (MAT) as a strategy for knee joint preservation, although to date, the effect of concomitant MAT on outcomes and failure rates after OCA has not been assessed.
PURPOSE: To determine clinical outcomes for patients undergoing OCA with MAT as compared with a matched cohort of patients undergoing isolated OCA. STUDY
DESIGN: Control study; Level of evidence, 3.
METHODS: Patients who underwent OCA of the medial or lateral femoral condyle without concomitant MAT by a single surgeon were compared with a matched group of patients who underwent OCA with concomitant MAT (ipsilateral compartment). The patients were matched per age, sex, body mass index, and number of previous ipsilateral knee operations ±1. Patient-reported outcomes, complications, reoperations, and survival rates were compared between groups.
RESULTS: One hundred patients undergoing OCA (50 isolated, 50 with MAT) with a mean ± SD follow-up of 4.9 ± 2.7 years (minimum, 2 years) were included (age, 31.7 ± 9.8 years; 52% male). Significantly more patients underwent OCA to the medial femoral condyle (n = 59) than the lateral femoral condyle (n = 41, P < .0001). Patients underwent 2.7 ± 1.7 operations on the ipsilateral knee before OCA. There were no significant differences between the groups regarding reoperation rate (n = 18 for OCA with MAT, n = 17 for OCA without MAT, P = .834), time to reoperation (2.2 ± 2.4 years for OCA with MAT, 3.4 ± 2.7 years for OCA without MAT, P = .149), or failure rates (n = 7 [14%] for OCA with MAT, n = 7 [14%] for OCA without MAT, P > .999). There were no significant differences in patient-reported clinical outcome scores between the groups at final follow-up. There was no significant difference in failure rates between patients undergoing medial femoral condyle OCA (n = 12, 15.3%) and lateral femoral condyle OCA (n = 5, 12.2%, P = .665).
CONCLUSION: These results imply that with appropriate surgical indications to address meniscus deficiency in patients otherwise indicated for OCA and despite the added surgical time and complexity of concomitant MAT, outcomes are favorable, with an 86% OCA graft survivorship at 5 years. This information can be used to counsel patients undergoing OCA with concomitant MAT as part of a knee joint preservation strategy.

Entities:  

Keywords:  clinical outcomes; concomitant versus staged; knee joint preservation; osteochondral allograft transplantation, meniscus allograft transplantation

Mesh:

Year:  2018        PMID: 29314864     DOI: 10.1177/0363546517744202

Source DB:  PubMed          Journal:  Am J Sports Med        ISSN: 0363-5465            Impact factor:   6.202


  3 in total

Review 1.  Osteochondral Allografts for Large Osteochondral Lesions of the Knee Joint: Indications, Surgical Techniques and Results.

Authors:  E Carlos Rodriguez-Merchan; Carlos A Encinas-Ullan; Alexander D Liddle
Journal:  Arch Bone Jt Surg       Date:  2022-03

Review 2.  Large Osteochondral Allografts of the Knee: Surgical Technique and Indications.

Authors:  Gabriele Pisanu; Umberto Cottino; Federica Rosso; Davide Blonna; Antonio Giulio Marmotti; Corrado Bertolo; Roberto Rossi; Davide E Bonasia
Journal:  Joints       Date:  2018-03-13

3.  The cost-effectiveness of osteochondral allograft transplantation in the knee.

Authors:  Hema Mistry; Andrew Metcalfe; Nick Smith; Emma Loveman; Jill Colquitt; Pamela Royle; Norman Waugh
Journal:  Knee Surg Sports Traumatol Arthrosc       Date:  2019-02-05       Impact factor: 4.342

  3 in total

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