Results of ultra-fresh osteochondral allograft transplantation for large cartilage defects in the knee joint

Jt Dis Relat Surg. 2022;33(3):521-530. doi: 10.52312/jdrs.2022.836. Epub 2022 Oct 21.

Abstract

Objectives: This study aims to investigate whether ultra-fresh osteochondral allograft (OCA) transplantation was a good therapeutic alternative for the treatment of otherwise challenging, massive osteochondral defects in the knee joint.

Patients and methods: Between April 2011 and July 2022, a total of 16 ultra-fresh knee transplantations (9 males, 7 females; median age: 30.2 years; range, 14 to 62 years) having large osteochondral defects on femoral condyles were included. The operations were performed by two surgeons. The condition of the patients were evaluated based on regular follow-up physical examinations, imaging studies and by recording and evaluating clinical scores (modified Cincinnati scores, and 2000 International Knee Documentation Committee [IKDC] scores).

Results: The median follow-up was 65±48 (range, 6 months to 12 years). At two years after transplantation, there was a significant improvement in the modified Cincinnati scores (preoperative score of 35.75 increased to 83.75; p<0.001) and also to the IKDC scores (preoperative score of 28.7 increased to 76.3; p<0.001). One patient developed an early septic complication, and another three patients underwent reoperation after the OCA transplantations for non-septic reasons.

Conclusion: Ultra-fresh OCA transplantation is a good therapeutic alternative for the treatment of otherwise challenging, massive osteochondral defects in the knee joint. Such a shortening of the transplantation time and its positive effect on the better long-term survival of transplanted chondrocytes has not yet been proven; however, the minimizing of transplantation time may create the conditions necessary for successful OCA transplantations many years after the implantation.

MeSH terms

  • Adult
  • Allografts
  • Bone Transplantation* / methods
  • Cartilage*
  • Female
  • Follow-Up Studies
  • Humans
  • Knee Joint / diagnostic imaging
  • Knee Joint / surgery
  • Male
  • Patient Satisfaction