Fresh osteochondral allografts for post-traumatic defects in the knee. A survivorship analysis

Abstract

Fresh osteochondral allografts were used to repair post-traumatic osteoarticular defects in 92 knees. At the time of grafting, varus or valgus deformities were corrected by upper tibial or supracondylar femoral osteotomies. A survivorship analysis was performed in which failure was defined as the need for a revision operation or the persistence of the pre-operative symptoms. There was a 75% success rate at five years, 64% at ten years and 63% at 14 years. The failure rate was higher for bipolar grafts than for unipolar and the results in patients over the age of 60 years were poor. The outcome did not depend on the sex of the patient and the results of allografts in the medial and lateral compartments of the knee were similar. Careful patient selection, correction of joint malalignment by osteotomy, and rigid fixation of the graft are all mandatory requirements for success. We recommend this method for the treatment of post-traumatic osteochondral defects in the knees of relatively young and active patients.

Fresh Osteochondral Allografts for Post-Traumatic Osteochondral Defects of the Knee

“…Our survivorship analysis has shown satisfactory results in 95% after five and in 77% after ten years. We have previously emphasised the importance of patient selection 11,[23][24][25][26] and confirm that young compliant patients with unipolar traumatic defects obtain the best results. [23][24][25] No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.…”

Knee salvage procedures: The indications, techniques and outcomes of large osteochondral allografts

“…Corrective osteotomy may be considered for any observed varus or valgus malalignment to return mechanical axis to neutral. Normal joint alignment is crucial for successful allograft transplantation [6] and it is essential to correct malalignment prior to implantation of allograft [18] . MRI is used to determine size, depth and condition of the lesion, as well as any associated meniscal or ligament deficiencies.…”

Cell Therapy and Tissular Engeenering to Regenerate Articular Cartilage

“…In addition, it is possible to retrieve the subchondral bone and the contour of the joint of patients with osteochondral defects or articular incongruity. The articular cartilage transplantation as part of an osteochondral graft provides the decrease in joint pain (Beaver et al, 1992), perhaps by the replacement of the innervated area of the subchondral bone by a graft without innervation.…”