Similar Outcomes After Osteochondral Allograft Transplantation in Anterior Cruciate Ligament-Intact and -Reconstructed Knees: A Comparative Matched-Group Analysis With Minimum 2-Year Follow-Up

Wang, Dean; Eliasberg, Claire D.; Wang, Yichen; Fader, Ryan R.; Coxe, Francesca R.; Pais, Mollyann D.; Williams, Riley J.

doi:10.1016/j.arthro.2017.06.034

Cited by 26 publications

(26 citation statements)

References 48 publications

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“…Much of the literature reporting on outcomes after mosaicplasty and OCA traditionally defined clinical success as it relates to graft survivorship, with failure defined by evidence of graft collapse, need for revision procedure, or conversion to arthroplasty. 13,18,26,[41][42][43] However, the patient population treated with cartilage repair is generally younger, and if unsatisfied, these patients often decide to cope with pain and continue nonoperative treatment for numerous years before eventually considering arthroplasty. As a result, better definitions of clinically meaningful improvement after cartilage restoration surgery are clearly desirable.…”

Section: Discussionmentioning

confidence: 99%

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Clinically Meaningful Improvement After Treatment of Cartilage Defects of the Knee With Osteochondral Grafts

et al. 2018

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Background: Mosaicplasty and fresh osteochondral allograft transplantation (OCA) are popular cartilage restoration techniques that involve the single-stage implantation of viable, mature hyaline cartilage-bone dowels into chondral lesions of the knee. Recently, there has been greater focus on what represents a clinically relevant change in outcomes reporting, and commonly applied metrics for measuring clinical significance include the minimal clinically important difference (MCID) and substantial clinical benefit (SCB). Purpose: To define the MCID and SCB after mosaicplasty or OCA for the International Knee Documentation Committee (IKDC) subjective form and Knee Outcome Survey-Activities of Daily Living (KOS-ADL) and to determine patient factors that are predictive of achieving the MCID and SCB after mosaicplasty or OCA.

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Section: Discussionmentioning

confidence: 99%

“…12,18,38 Additionally, several comparative studies suggested that ACL reconstruction and meniscal allograft transplantation do not negatively affect the patient-reported outcomes of OCA. 11,39,41…”

Section: Discussionmentioning

confidence: 99%

Clinically Meaningful Improvement After Treatment of Cartilage Defects of the Knee With Osteochondral Grafts

et al. 2018

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“…Another study comes from the New York Hospital for Special Surgery group, with data prospectively collected by Riley Williams and colleagues from 1999. They have provided a series of papers looking at subgroups, showing that results of OCA are no worse in patients who have had anterior cruciate ligament reconstruction (ACLR) [ 64 ] or in those with Body Mass Index (BMIs) over 30 (graft survival 83% at 5 years) [ 49 ]. They also found that results in patients aged over 40 (mean age 48, range 40–63 years) were also good, with graft survival 73% at 4 years [ 65 ].…”

Section: Evidence: Primary Studiesmentioning

confidence: 99%

The cost-effectiveness of osteochondral allograft transplantation in the knee

Mistry

Metcalfe

Smith

et al. 2019

Knee Surg Sports Traumatol Arthrosc

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Purpose Osteochondral allografts (OCA) consist of a layer of hyaline cartilage and a layer of underlying bone. They are used to repair combined defects of articular cartilage and bone. Such defects often occur in people far too young to have knee arthroplasty, for whom the main alternative to OCA is conservative symptomatic care, which will not prevent development of osteoarthritis. The aim of this report was to assess the cost-effectiveness of osteochondral allograft transplantation in the knee. Methods Systematic review of evidence on clinical effectiveness and economic modelling. Results The evidence on osteochondral allograft transplantation comes from observational studies, but often based on good quality prospective registries of all patients having such surgery. Without controlled trials, it was necessary to use historical cohorts to assess the effect of osteochondral grafts. There is good evidence that OCA are clinically effective with a high graft survival rate over 20 years. If an OCA graft fails, there is some evidence that revision with a second OCA is also effective, though less so than primary OCA. Economic modelling showed that osteochondral allograft transplantation was highly cost-effective, with costs per quality adjusted life year much lower than many other treatments considered cost effective. Conclusions Osteochondral allograft transplantation appears highly cost-effective though the cost per quality adjusted life year varies according to the widely varying costs of allografts. Based on one small study, revision OCA also appears very cost-effective, but more evidence is needed. Level of evidence II. Electronic supplementary material The online version of this article (10.1007/s00167-019-05392-8) contains supplementary material, which is available to authorized users.

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“…The indications for the procedure include the following: age younger than 50 years, body mass index lower than 35, previously unsuccessful conservative or surgical interventions, focal grade III to IV osteochondral defects of the femoral condyle diagnosed by magnetic resonance imaging (MRI) (Fig 1) or arthroscopy, normal or correctable alignment, normal or correctable ligamentous stability, normal or correctable meniscal integrity, willingness to comply with the rehabilitation protocol, and realistic postsurgical expectations 3, 5, 6, 7, 9, 13, 15, 16. Although more controversial, the contraindications include obesity, generalized osteoarthritis, osteonecrosis, active infection or bone cancer, and lack of corresponding symptoms 7, 9, 10, 13, 16Fig 1Magnetic resonance imaging of the left knee.…”

Section: Indicationsmentioning

confidence: 99%

Osteochondral Autograft Transfer Procedure: Arthroscopic Technique and Technical Pearls

Rowland

Colello

Wyland

2019

Arthroscopy Techniques

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The Osteochondral Autograft Transfer System (OATS; Arthrex, Naples, FL) is an excellent option for the treatment of articular cartilage lesions within the knee. Current literature suggests that at early-term to midterm follow-up, patients experience improved function, alleviation of pain, and good satisfaction with acceptable complication rates. Although long-term data are lacking, studies in athletes have shown that the OATS can provide an adequate rate of return to sports. The OATS procedure has traditionally been considered an open procedure. However, with the advancement of arthroscopic techniques, the procedure can now be completed arthroscopically. We discuss this modern operation.

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Similar Outcomes After Osteochondral Allograft Transplantation in Anterior Cruciate Ligament-Intact and -Reconstructed Knees: A Comparative Matched-Group Analysis With Minimum 2-Year Follow-Up

Cited by 26 publications

References 48 publications

Clinically Meaningful Improvement After Treatment of Cartilage Defects of the Knee With Osteochondral Grafts

Clinically Meaningful Improvement After Treatment of Cartilage Defects of the Knee With Osteochondral Grafts

The cost-effectiveness of osteochondral allograft transplantation in the knee

Osteochondral Autograft Transfer Procedure: Arthroscopic Technique and Technical Pearls

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