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Published on: May 21, 2013
Revision osteochondral allograft transplantations: do they work?
Melissa T Horton1, Pamela A Pulido, Julie C McCauley
1William D. Bugbee, Scripps Clinic, Division of Orthopaedic Surgery, 10666 North Torrey Pines Road, MS116, La Jolla, CA 92037. Bugbee.William@scrippshealth.org.
The American Journal of Sports Medicine
|August 29, 2013
Summary
Revision osteochondral allograft transplantation for knee injuries shows improved pain and function. While outcomes are less favorable than primary procedures, it offers a viable option for failed primary grafts, with 61% graft survival at 10 years.
Area of Science:
- Orthopedic surgery
- Regenerative medicine
- Biomaterials science
Background:
- Primary fresh osteochondral allograft transplantation is a recognized treatment for knee osteochondral lesions.
- Clinical failure of primary grafts may necessitate revision procedures, such as revision osteochondral allograft transplantation.
Purpose of the Study:
- To evaluate the clinical outcomes and graft survivorship following revision osteochondral allograft transplantation of the knee.
Main Methods:
- A case series (Level of evidence, 4) involving 33 patients who underwent revision osteochondral allograft transplantation.
- Minimum 2-year follow-up was required, with clinical assessments using validated scoring systems (IKDC, Knee Society, Merle d'Aubigné and Postel).
- Graft failure was defined as conversion to knee arthroplasty.
Main Results:
- Mean follow-up was 10 years, with 61% of revision allografts surviving at this time point.
- Thirteen patients (39%) experienced graft failure at a mean of 5.5 years post-revision.
- Patients with surviving grafts demonstrated improved mean pain and function scores.
Conclusions:
- Revision osteochondral allograft transplantation yields acceptable clinical outcomes for the knee, though generally inferior to primary procedures.
- This technique can be considered a viable surgical option for patients with failed primary osteochondral allografts.
