Osteochondral Allograft Transplantation in Patients With Osteochondritis Dissecans of the Knee

Sadr, Kamran N.; Pulido, Pamela A.; McCauley, Julie C.; Bugbee, William D.

doi:10.1177/0363546516657526

Cited by 89 publications

(99 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…9,14 Osteochondral lesions present a unique challenge because of the combined bone and hyaline cartilage tissue injury or deficit, requiring techniques that address both bone and cartilage deficiency. Good to excellent outcomes (reduction in pain, improvement in function, high patient satisfaction) in the treatment of large osteochondral lesions such as osteochondritis dissecans, 11,31,34 fracture, 33 and secondary osteonecrosis 16 have been reported with the use of fresh OCA transplant. OCA transplant is uniquely suited for these clinical situations by virtue of its ability to restore both osseous and chondral tissue in a precise, anatomically identical fashion.…”

Section: Discussionmentioning

confidence: 99%

Fresh Osteochondral Allograft Transplantation for Spontaneous Osteonecrosis of the Knee: A Case Series

Tírico

Early

McCauley

et al. 2017

Orthopaedic Journal of Sports Medicine

Self Cite

View full text Add to dashboard Cite

Background:Spontaneous osteonecrosis of the knee (SONK) is a clinical entity identified by acute knee pain usually associated with joint effusion, with radiographic findings of a radiolucent defect on the weightbearing area of the femoral condyle. Conservative treatment is initially undertaken; however, surgical procedures are often necessary. Historically, surgical options have included core decompression, cartilage repair, high tibial osteotomy, or joint arthroplasty. Few studies in the literature have reported the use of fresh osteochondral allograft (OCA) for the treatment of SONK lesions.Hypothesis:OCA transplantation is an effective treatment for SONK lesions on the medial femoral condyle.Study Design:Case series; Level of evidence, 4.Methods:A case series was analyzed of 7 patients treated with OCA for large SONK lesions of the medial femoral condyle with a minimum 4-year follow-up. All patients experienced failure of at least 6 months of conservative treatment and declined arthroplasty as the form of definitive treatment for medial femoral condyle lesion. All patients underwent OCA of the medial femoral condyle. Mean lesion size was 4.6 cm2 (range, 3.24-6.25 cm2), with a mean condylar width of 41.7 mm (range, 35.4-48.6 mm), resulting in a median proportion (lesion size/condylar width) of 56.8% (range, 32.7%-62.6%). The median surface allograft area was 5.1 cm2 (range, 3.2-6.3 cm2).Results:The median follow-up was 7.1 years (range, 4.5-14.1 years). No patient had additional surgery following OCA transplant; the allograft failure rate was 0%. Subjective outcome scores from the International Knee Documentation Committee, Knee injury and Osteoarthritis Outcome Score, and modified Merle d’Aubigné-Postel scale improved from preoperative assessment to the latest follow-up. All patients were extremely satisfied with the results of the OCA transplant.Conclusion:Fresh OCA transplantation demonstrated excellent efficacy, durability, and satisfaction in this group of patients with isolated stage 2 and 3 SONK lesions who had experienced failure of conservative treatment. Fresh osteochondral allografts are an attractive method for surgical management of selected patients with spontaneous osteonecrosis of the knee.

show abstract

Section: Discussionmentioning

confidence: 99%

Fresh Osteochondral Allograft Transplantation for Spontaneous Osteonecrosis of the Knee: A Case Series

Tírico

Early

McCauley

et al. 2017

Orthopaedic Journal of Sports Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

“…OCA is primarily used in the management of large osteochondral defects and as a salvage option for those who have previously failed other cartilage repair techniques. Fresh osteochondral allograft transplantation is theoretically an attractive option because it can restore both the osseous and the chondral components caused by the OCD lesion [101].…”

Section: Allograft Transplantationmentioning

confidence: 99%

“…Osteoarthritis or the presence of disease on both articular surfaces is a contraindication to OCA [111]. The number of previous ipsilateral knee surgical procedures, elevated BMI, age >30 years old, and medial femoral graft location have been found to be independent factors predictive of reoperation and failure after allograft transplantation [101,112].…”

Section: Allograft Transplantationmentioning

confidence: 99%

Osteochondritis Dissecans of the Knee

Egger¹,

Saluan²

2018

Cartilage Repair and Regeneration

View full text Add to dashboard Cite

Osteochondritis dissecans (OCD) is a common but poorly understood source of knee pain and dysfunction. It is a condition primarily affecting the subchondral bone, with secondary effects on the articular cartilage surface. A large amount of research over the past two decades has produced many valuable insights into the condition, but further study and elucidation are still needed. The goal of this chapter will be to serve as a general overview of osteochondritis dissecans as it is understood today, including the etiology, clinical presentation, diagnosis, treatment options, outcomes, and future research aims.

show abstract

“…Sadr et al 26 had135 patients with 149 knees who had OCD that was treated with fresh osteochondral grafts that recovered within 24 hours of death until the time of implantation, between 7 and 28 days. Surgery was performed through a midline skin incision with a small arthrotomy.…”

Section: Level Of Evidencementioning

confidence: 99%

Systematic Review : Osteochondral Allograft in Treatment of Knee Articular Cartilage Injuries

Elsaeed

Elseddawy

Abdelwahed

2017

Egyptian Journal of Hospital Medicine

View full text Add to dashboard Cite

Purpose: The objectives of this study were designed to conduct a systematic review of clinical outcomes after osteochondral allograft transplantation in the knee and to identify patients, defects, and graft-specific prognostic factors. Methods: We searched PubMed, Medline, EMBASE, and the Cochrane Central Register of Controlled Trials. Studies that evaluated clinical outcomes in patients after osteochondral allograft transplantation for chondral defects in the knee were included. Results: There were 11 eligible studies resulting in 550 knees with a mean follow-up of 150 months (range, 30 to 261 months). The overall follow-up rate was 93%. The mean age was 31 years (range, 15 to 52 years), and 478 patients (63%) were men. With regard to etiology, the most common indications for transplantation included post-traumatic (38%), osteochondritis dissecans (31%), osteonecrosis from all causes (12%), AVN (1%) and idiopathic (9%). 63% of patients had concomitant procedures, and the mean defect size across studies was 6.3 cm2. The overall satisfaction rate was 93%. Conclusions: Osteochondral allograft transplantation for focal and diffuse chondral defects results in predictably favorable outcomes and high satisfaction rates. Patients with osteochondritis dissecans, traumatic and idiopathic etiologies have more favorable outcomes as younger patients with unipolar lesions and short symptom duration. Future studies should include comparative control groups and use established outcome instruments that will allow for pooling of data across studies. The level of Evidence: Level IV, a systematic review of Level IV studies.

show abstract

Osteochondral Allograft Transplantation in Patients With Osteochondritis Dissecans of the Knee

Abstract: OCA transplantation was an effective treatment for OCD of the knee, with a low rate of graft failure, significant improvement in pain and function scores, and high patient satisfaction.

Cited by 89 publications

References 33 publications

Fresh Osteochondral Allograft Transplantation for Spontaneous Osteonecrosis of the Knee: A Case Series

Fresh Osteochondral Allograft Transplantation for Spontaneous Osteonecrosis of the Knee: A Case Series

Osteochondritis Dissecans of the Knee

Systematic Review : Osteochondral Allograft in Treatment of Knee Articular Cartilage Injuries

Contact Info

Product

Resources

About