Kylee Rucinski1, James P Stannard2, Cory Crecelius1, James L Cook3. 1. Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA; Mizzou BioJoint Center, University of Missouri, Columbia, MO, USA. 2. Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA; Mizzou BioJoint Center, University of Missouri, Columbia, MO, USA; Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, MO, USA. 3. Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA; Mizzou BioJoint Center, University of Missouri, Columbia, MO, USA; Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, MO, USA. Electronic address: cookjl@health.missouri.edu.
Abstract
BACKGROUND: Our study purpose was to determine if primary osteochondral allograft (OCA) transplant surgeries for large (>4 cm2) single-surface, multisurface, or bipolar articular defects in the knee would be associated with significant gains in knee range of motion (ROM) at ≥1-year follow-up when compared to preoperative ROM. METHODS: Patients were prospectively enrolled into a dedicated registry to follow outcomes after OCA with or without meniscal allograft transplantation using Missouri Osteochondral Preservation System (MOPS)-preserved allografts. Patients were included if they had surgery to repair at least one osteochondral defect, and when at least one year of ROM data and Visual Analog Scale pain scores were available. Data on complications and reoperations, patient-reported outcome measures, compliance with rehabilitation, revisions, or failures were recorded. RESULTS: For patients who met inclusion criteria after OCA surgery (n = 75), overall ROM increased from 127.8 ± 17 degrees preoperatively, to 130.5 ± 14 post-operatively. Non-compliance was the largest factor contributing to postoperative ROM lag or loss. Knee manipulation/lysis of adhesion rates were comparable to rates in TKA and ACL procedures (2.96-4.54% for ACL/TKA, 4% for OCAs in the present study). CONCLUSION: Results suggest that OCA with or without meniscal allograft transplantation in the knee using high-viability grafts, advanced graft cutting and implantation techniques, and procedure-specific rehabilitation protocols can result in consistently successful outcomes in a high percentage (92%) of selected patients. Most patients (95%) can expect to regain, or improve, to "full" functional range of motion (130°) at 1 year after surgery such that highly functional activities can be performed. LEVEL OF EVIDENCE: Cohort study; Level III.
BACKGROUND: Our study purpose was to determine if primary osteochondral allograft (OCA) transplant surgeries for large (>4 cm2) single-surface, multisurface, or bipolar articular defects in the knee would be associated with significant gains in knee range of motion (ROM) at ≥1-year follow-up when compared to preoperative ROM. METHODS:Patients were prospectively enrolled into a dedicated registry to follow outcomes after OCA with or without meniscal allograft transplantation using Missouri Osteochondral Preservation System (MOPS)-preserved allografts. Patients were included if they had surgery to repair at least one osteochondral defect, and when at least one year of ROM data and Visual Analog Scale pain scores were available. Data on complications and reoperations, patient-reported outcome measures, compliance with rehabilitation, revisions, or failures were recorded. RESULTS: For patients who met inclusion criteria after OCA surgery (n = 75), overall ROM increased from 127.8 ± 17 degrees preoperatively, to 130.5 ± 14 post-operatively. Non-compliance was the largest factor contributing to postoperative ROM lag or loss. Knee manipulation/lysis of adhesion rates were comparable to rates in TKA and ACL procedures (2.96-4.54% for ACL/TKA, 4% for OCAs in the present study). CONCLUSION: Results suggest that OCA with or without meniscal allograft transplantation in the knee using high-viability grafts, advanced graft cutting and implantation techniques, and procedure-specific rehabilitation protocols can result in consistently successful outcomes in a high percentage (92%) of selected patients. Most patients (95%) can expect to regain, or improve, to "full" functional range of motion (130°) at 1 year after surgery such that highly functional activities can be performed. LEVEL OF EVIDENCE: Cohort study; Level III.
Authors: James L Cook; James P Stannard; Aaron M Stoker; Kylee Rucinski; Brett D Crist; Cristi R Cook; Cory Crecelius; Matthew J Smith; Renee Stucky Journal: Mo Med Date: 2022 Mar-Apr