Editorial Commentary: Osteochondral Allograft Outcomes Are Durable at Longer Follow-Up

Patients with chondral and osteochondral lesions often present with debilitating symptoms. Several treatments are available, ranging from microfracture and autologous chondrocyte implantation to osteochondral autograft and osteochondral allograft transplantation (OCA). Over the last 2 decades, significant improvement in the indications, graft storage and surgical outcomes of OCA have been seen with excellent patient-reported outcome measures and reliable return-to-sports rates. Long-term studies identifying risk factors for graft failure or disappointing subjective outcomes are important to further understand the ideal candidate for OCA. Studies have identified coronal malalignment, ligament instability, meniscal insufficiency, higher body mass index, older age, and longer duration of symptoms as risk factors for failure, and corresponding concomitant procedures often are performed with OCA to improve success rates. Future larger studies are needed to further identify predictors of success, preferably larger cohorts in which confounders and other factors can be accounted and corrected for. OCA remains an excellent treatment for osteochondral lesions with durable outcomes at long-term follow-up.