Return to Sport After Large Single-Surface, Multisurface, or Bipolar Osteochondral Allograft Transplantation in the Knee Using Shell Grafts.

BACKGROUND

Return to sport (RTS) after osteochondral allograft (OCA) transplantation for large unipolar femoral condyle defects has been consistent, but many athletes are affected by more severe lesions.

PURPOSE

To examine outcomes for athletes who have undergone large single-surface, multisurface, or bipolar shell OCA transplantation in the knee.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

Data from a prospective OCA transplantation registry were assessed for athletes who underwent knee transplantation for the first time (primary transplant) between June 2015 and March 2018 for injury or overuse-related articular defects. Inclusion criteria were preinjury Tegner level ≥5 and documented type and level of sport (or elite unit active military duty); in addition, patients were required to have a minimum of 1-year follow-up outcomes, including RTS data. Patient characteristics, surgery type, Tegner level, RTS, patient-reported outcome measures (PROMs), compliance with rehabilitation, revisions, and failures were assessed and compared for statistically significant differences.

RESULTS

There were 37 included athletes (mean age, 34 years; range, 15-69 years; mean body mass index, 26.2 kg/m

CONCLUSION

Large single-surface, multisurface, or bipolar shell OCA knee transplantations in athletes resulted in two-thirds of these patients returning to sport at 16 to 24 months after transplantation. Combined, the revision and failure rates were 10%; thus, 90% of patients were considered to have successful 2- to 4-year outcomes with significant improvements in pain and function, even when patients did not RTS.

Informations de copyright

© The Author(s) 2021.

Déclaration de conflit d'intérêts

One or more of the authors has declared the following potential conflict of interest or source of funding: J.L.C. is a member of the medical board of trustees of the Musculoskeletal Transplant Foundation (MTF), which licenses the Missouri Osteochondral Preservation System (MOPS) used in the allograft procedures described in this study. J.L.C. and J.P.S. have received funding from the US Department of Defense and MTF related to this line of research conducted at the University of Missouri. J.L.C. has also received research support from Arthrex, the Coulter Foundation, DePuy Synthes, GE Healthcare, Merial, the MTF, Purina, and Zimmer Biomet; consulting fees from Arthrex and Trupanion; and speaking fees and royalties from Arthrex; and is a board member for the Midwest Transplant Network and MTF. J.P.S. has received research support from the Coulter Foundation; consulting fees from Acelity, Arthrex, DePuy Synthes, NuVasive, Orthopedic Designs North America, and Smith & Nephew; nonconsulting fees from Arthrex and Smtih & Nephew; faculty/speaker fees from DePuy; and royalties from Thieme. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.