Gergo Merkely1,2, Takahiro Ogura1,3, Jakob Ackermann1, Alexandre Barbieri Mestriner1,4, Andreas H Gomoll1,5. 1. Cartilage Repair Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. 2. Department of Traumatology, Semmelweis University, Budapest, Hungary. 3. Sports Medicine Center, Funabashi Orthopaedic Hospital, Funabashi, Chiba, Japan. 4. Universidade Federal de São Paulo, São Paulo, Brazil. 5. Hospital for Special Surgery, New York, New York, USA.
Abstract
OBJECTIVE: Osteochondral allograft transplantation (OCA) is a well-established procedure for patients with symptomatic cartilage defects in the knee. Revision to OCA after prior failed cartilage repair has shown similar clinical outcomes as primary OCA; however, most of the failed procedures were arthroscopic procedures for smaller defects. There is no literature investigating the clinical outcomes after OCA for prior failed autologous chondrocyte implantation (ACI) for the treatment of large chondral defects of the knee. The purpose of this study was therefore to determine clinical outcomes of patients undergoing revision to OCA after prior failed ACI as compared with a matched cohort of patients undergoing OCA as a primary cartilage repair procedure (primary OCA). DESIGN: In this review of prospectively collected data, we analyzed data from 26 patients with at least 2 years follow-up. Thirteen patients who underwent revision to OCA after prior failed ACI by a single surgeon were compared with a matched group of patients who underwent primary OCA. The patients were matched per age, gender, body mass index, and defect size. Patient-reported outcomes, reoperations, and survival rates were compared between groups. RESULTS: There were no significant differences in patient-reported clinical outcome scores between the groups at final follow-up. Moreover, there was no significant difference in reoperation rates and survival rates between the groups. CONCLUSION: The present study demonstrates that revision to OCA is a viable treatment option with favorable functional outcomes and similar reoperation and survival rate as primary OCA even for revision of large chondral defects previously treated with ACI.
OBJECTIVE: Osteochondral allograft transplantation (OCA) is a well-established procedure for patients with symptomatic cartilage defects in the knee. Revision to OCA after prior failed cartilage repair has shown similar clinical outcomes as primary OCA; however, most of the failed procedures were arthroscopic procedures for smaller defects. There is no literature investigating the clinical outcomes after OCA for prior failed autologous chondrocyte implantation (ACI) for the treatment of large chondral defects of the knee. The purpose of this study was therefore to determine clinical outcomes of patients undergoing revision to OCA after prior failed ACI as compared with a matched cohort of patients undergoing OCA as a primary cartilage repair procedure (primary OCA). DESIGN: In this review of prospectively collected data, we analyzed data from 26 patients with at least 2 years follow-up. Thirteen patients who underwent revision to OCA after prior failed ACI by a single surgeon were compared with a matched group of patients who underwent primary OCA. The patients were matched per age, gender, body mass index, and defect size. Patient-reported outcomes, reoperations, and survival rates were compared between groups. RESULTS: There were no significant differences in patient-reported clinical outcome scores between the groups at final follow-up. Moreover, there was no significant difference in reoperation rates and survival rates between the groups. CONCLUSION: The present study demonstrates that revision to OCA is a viable treatment option with favorable functional outcomes and similar reoperation and survival rate as primary OCA even for revision of large chondral defects previously treated with ACI.
Authors: László Hangody; Jozsef Dobos; Eszter Baló; Gergely Pánics; Laszlo Rudolf Hangody; Istvan Berkes Journal: Am J Sports Med Date: 2010-04-01 Impact factor: 6.202
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Authors: Simon Görtz; Suzanne M Tabbaa; Deryk G Jones; John D Polousky; Dennis C Crawford; William D Bugbee; Brian J Cole; Jack Farr; James E Fleischli; Alan Getgood; Andreas H Gomoll; Allan E Gross; Aaron J Krych; Christian Lattermann; Bert R Mandelbaum; Peter R Mandt; Raffy Mirzayan; Timothy S Mologne; Matthew T Provencher; Scott A Rodeo; Oleg Safir; Eric D Strauss; Christopher J Wahl; Riley J Williams; Adam B Yanke Journal: Orthop J Sports Med Date: 2021-03-23