Fresh osteochondral allograft transplantation for isolated patellar cartilage injury.

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  • Additional Information
    • Source:
      Publisher: Sage Publications Country of Publication: United States NLM ID: 7609541 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1552-3365 (Electronic) Linking ISSN: 03635465 NLM ISO Abbreviation: Am J Sports Med Subsets: MEDLINE
    • Publication Information:
      Publication: 2004- : Thousand Oaks, CA : Sage Publications
      Original Publication: Baltimore, Williams & Wilkins.
    • Subject Terms:
      Bone Transplantation/*methods ; Cartilage/*transplantation ; Knee Joint/*surgery ; Patella/*surgery; Adolescent ; Adult ; Arthroplasty, Replacement, Knee ; Cartilage/injuries ; Female ; Follow-Up Studies ; Humans ; Knee Joint/pathology ; Male ; Middle Aged ; Orthopedic Procedures/methods ; Patella/injuries ; Patient Satisfaction ; Reoperation ; Transplantation, Homologous ; Young Adult
    • Abstract:
      Background: The treatment of patellofemoral cartilage injuries can be challenging. Osteochondral allograft (OCA) transplantation has been used as a treatment option for a range of cartilage disorders.
      Purpose: To evaluate functional outcomes and survivorship of the grafts among patients who underwent OCA for patellar cartilage injuries.
      Study Design: Case series; Level of evidence, 4.
      Methods: An institutional review board-approved OCA database was used to identify 27 patients (28 knees) who underwent isolated OCA transplantation of the patella between 1983 and 2010. All patients had a minimum 2-year follow-up. The mean age of the patients was 33.7 years (range, 14-64 years); 54% were female. Twenty-six (92.9%) knees had previous surgery (mean, 3.2 procedures; range, 1-10 procedures). The mean allograft area was 10.1 cm(2) (range, 4.0-18.0 cm(2)). Patients returned for clinical evaluation or were contacted via telephone for follow-up. The number and type of reoperations were assessed. Any reoperation resulting in removal of the allograft was considered a failure of the OCA transplantation. Patients were evaluated pre- and postoperatively using the modified Merle d'Aubigné-Postel (18-point) scale, the International Knee Documentation Committee (IKDC) pain, function, and total scores, and the Knee Society function (KS-F) score. Patient satisfaction was assessed at latest follow-up.
      Results: Seventeen of the 28 knees (60.7%) had further surgery after the OCA transplantation; 8 of the 28 knees (28.6%) were considered OCA failures (4 conversions to total knee arthroplasty, 2 conversions to patellofemoral knee arthroplasty, 1 revision OCA, 1 patellectomy). Patellar allografting survivorship was 78.1% at 5 and 10 years and 55.8% at 15 years. Among the 20 knees (71.4%) with grafts in situ, the mean follow-up duration was 9.7 years (range, 1.8-30.1 years). Pain and function improved from the preoperative visit to latest follow-up, and 89% of patients were extremely satisfied or satisfied with the results of the OCA transplantation.
      Conclusion: OCA transplantation was successful as a salvage treatment procedure for cartilage injuries of the patella.
      (© 2015 The Author(s).)
    • Contributed Indexing:
      Keywords: cartilage; osteochondral allograft; osteochondral defect; osteochondral transplantation; patella
    • Publication Date:
      Date Created: 20150118 Date Completed: 20150909 Latest Revision: 20220408
    • Publication Date:
      20221213
    • Accession Number:
      10.1177/0363546514564144
    • Accession Number:
      25596614