Document Detail

Do fresh osteochondral allografts successfully treat femoral condyle lesions?
MedLine Citation:
PMID:  22961315     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Fresh osteochondral allograft transplantation is an increasingly common treatment option for chondral and osteochondral lesions in the knee, but the long-term outcome is unknown.
QUESTIONS/PURPOSES: We determined (1) pain and function, (2) frequency and types of reoperations, (3) survivorship at a median of 13.5 years, and (4) predictors of osteochondral allograft failure in the distal femur.
METHODS: We evaluated 122 patients (129 knees) who underwent osteochondral allograft transplantation of the femoral condyle. Mean age was 33 years and 53% were male. Clinical evaluation included the modified Merle d'Aubigné-Postel (18-point), IKDC, and Knee Society function (KS-F) scores. We defined graft failure as revision osteochondral allografting or conversion to arthroplasty. We determined whether patient characteristics or attributes of the graft influenced failure. Minimum followup was 2.4 years (median, 13.5 years); 91% had more than 10 years of followup.
RESULTS: Mean modified Merle d'Aubigné-Postel score improved from 12.1 to 16, mean IKDC pain score from 7.0 to 3.8, mean IKDC function score from 3.4 to 7.2, and mean KS-F score from 65.6 to 82.5. Sixty-one knees (47%) underwent reoperations. Thirty-one knees (24%) failed at a mean of 7.2 years. Survivorship was 82% at 10 years, 74% at 15 years, and 66% at 20 years. Age of more than 30 years at time of surgery and having two or more previous surgeries for the operated knee were associated with allograft failure.
CONCLUSIONS: Followup of femoral condyle osteochondral allografting demonstrated durable improvement in pain and function, with graft survivorship of 82% at 10 years.
Yadin D Levy; Simon Görtz; Pamela A Pulido; Julie C McCauley; William D Bugbee
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  471     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-24     Completed Date:  2013-05-28     Revised Date:  2014-01-09    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  231-7     Citation Subset:  AIM; IM    
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MeSH Terms
Bone Transplantation / methods*
Cartilage, Articular / pathology,  surgery
Femur / pathology,  surgery*
Follow-Up Studies
Graft Survival*
Knee Injuries / pathology,  surgery*
Knee Joint / pathology,  surgery*
Middle Aged
Osteochondritis Dissecans / pathology,  surgery*
Transplantation, Homologous
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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