Validation of the Oswestry Risk of Knee Arthroplasty Index (ORKA-1) for Patients Undergoing Autologous Chondrocyte Implantation.

Publisher: Sage Country of Publication: United States NLM ID: 101518378 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1947-6043 (Electronic) Linking ISSN: 19476035 NLM ISO Abbreviation: Cartilage Subsets: MEDLINE

Original Publication: Los Angeles : Sage

Arthroplasty, Replacement, Knee/*statistics & numerical data ; Cartilage Diseases/*surgery ; Chondrocytes/*transplantation ; Knee/*surgery ; Risk Assessment/*standards; Adolescent ; Adult ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Predictive Value of Tests ; Preoperative Period ; Proportional Hazards Models ; Prospective Studies ; Risk Factors ; Transplantation, Autologous/statistics & numerical data ; Treatment Failure ; United States ; Young Adult

Objective: The purpose of this study was first to externally validate the Oswestry Risk of Knee Arthroplasty index (ORKA-1) by applying it to an autologous chondrocyte implantation (ACI) patient cohort in the United States with a broader definition of failure than only arthroplasty, and second, to determine predictive factors for the risk of ACI failure as defined by the senior author.
Design: A total of 171 patients that underwent ACI were included to validate the ORKA-1 as all factors needed for calculation and outcomes were recorded. For Cox regression analysis, 154 patients were included as they completed preoperative Knee Injury and Osteoarthritis Outcome Score (KOOS), Tegner, Lysholm, International Knee Documentation Committee (IKDC), and 12-item Shor Form (SF-12) scores. Patient- and lesion-associated parameters were recorded for each patient.
Results: At final follow-up (maximum of 10 years post-ACI), a total of 27 patients (15.8%) were considered a failure by senior author's definition. With ACI failure as endpoint, the mean survival was 7.96 years in risk group 1 and 5.4 years in risk group 5. Cox regression analysis identified preoperative KOOS Sport/Recreation as the only significant predictive factor for ACI failure ( P = 0.007).
Conclusion: The ORKA-1 is a helpful tool for surgeons to estimate an individual patient's likelihood of ACI survival. Further studies with larger patient cohorts as well as a consensus definition of failure are needed to further refine predictors of ACI failure.

Clin Orthop Relat Res. 2014 Jan;472(1):41-51. (PMID: 23979923)
N Engl J Med. 1994 Oct 6;331(14):889-95. (PMID: 8078550)
Osteoarthritis Cartilage. 2011 Jul;19(7):779-91. (PMID: 21333744)
Am J Sports Med. 2009 Nov;37 Suppl 1:10S-19S. (PMID: 19846694)
Sports Med Arthrosc Rev. 2017 Mar;25(1):10-18. (PMID: 28045868)
Am J Sports Med. 2010 May;38(5):943-9. (PMID: 20185841)
J Rheumatol. 2002 Jun;29(6):1273-9. (PMID: 12064846)
Am J Sports Med. 2008 Feb;36(2):235-46. (PMID: 18202295)
Am J Sports Med. 2017 Oct;45(12):2751-2761. (PMID: 28745972)
Cartilage. 2017 Apr;8(2):119-130. (PMID: 28345413)
J Bone Joint Surg Br. 2006 Jan;88(1):61-4. (PMID: 16365122)
Cartilage. 2012 Jan;3(1):13-9. (PMID: 26069615)
Curr Rev Musculoskelet Med. 2012 Sep;5(3):229-35. (PMID: 22628178)
Am J Sports Med. 2010 Feb;38(2):238-46. (PMID: 20448191)
Am J Sports Med. 2009 Nov;37 Suppl 1:131S-8S. (PMID: 19861698)
Health Technol Assess. 2017 Feb;21(6):1-294. (PMID: 28244303)
Am J Sports Med. 2009 Jul;37(7):1344-50. (PMID: 19286911)
Injury. 2008 Apr;39 Suppl 1:S40-9. (PMID: 18313471)
J Bone Joint Surg Am. 2007 Oct;89(10):2105-12. (PMID: 17908884)
Cartilage. 2016 Oct;7(4):298-308. (PMID: 27688838)
Knee Surg Sports Traumatol Arthrosc. 2010 Apr;18(4):519-27. (PMID: 20062969)
Value Health. 2010 Jun-Jul;13(4):447-54. (PMID: 20088892)
J Bone Joint Surg Am. 2004 Mar;86(3):455-64. (PMID: 14996869)
Am J Sports Med. 2010 Jun;38(6):1117-24. (PMID: 20181804)

Keywords: arthroplasty; autologous chondrocyte; diagnosis; failure; grafts; knee pain; osteoarthritis

Date Created: 20180828 Date Completed: 20210805 Latest Revision: 20210805

20231215

PMC7488946

10.1177/1947603518796146

30146892