Comparison of Outcomes After Primary Versus Salvage Osteochondral Allograft Transplantation for Femoral Condyle Osteochondritis Dissecans Lesions.

Background

Osteochondral allograft transplantation (OCAT) allows the restoration of femoral condyle osteochondritis dissecans (OCD) lesions using an osteochondral unit. When OCD lesions are irreparable, or treatments have failed, OCAT is an appropriate approach for revision or salvage surgery. Based on its relative availability, cost-effectiveness, lack of donor site morbidity, and advances in preservation methods, OCAT is also an attractive option for primary surgical treatment for femoral condyle OCD.

Hypothesis

OCAT for large femoral condyle OCD lesions would be highly successful (>90%) based on significant improvements in knee pain and function, with no significant differences between primary and salvage procedure outcomes.

Study Design

Cohort study; Level of evidence, 3.

Methods

Patients were enrolled into a registry for assessing outcomes after OCAT. Those patients who underwent OCAT for femoral condyle OCD and had a minimum of 2-year follow-up were included. Reoperations, treatment failures, and patient-reported outcomes were compared between primary and salvage OCAT cohorts.

Results

A total of 22 consecutive patients were included for analysis, with none lost to the 2-year follow-up (mean, 40.3 months; range, 24-82 months). OCD lesions of the medial femoral condyle (n = 17), lateral femoral condyle (n = 4), or both condyles (n = 1) were analyzed. The mean patient age was 25.3 years (range, 12-50 years), and the mean body mass index was 25.2 kg/m

Conclusion

Based on the low treatment failure rates in conjunction with statistically significant and clinically meaningful improvements in patient-reported outcomes, OCAT can be considered an appropriate option for both primary and salvage surgical treatment in patients with irreparable OCD lesions of the femoral condyles.

Informations de copyright

© The Author(s) 2024.

Déclaration de conflit d'intérêts

One or more of the authors has declared the following potential conflict of interest or source of funding: C.N. has received financial or material support from AO Foundation and Arthroscopy; education payments from Arthrex and Elite Orthopedics; consulting fees from Arthrex and Guidepoint Consulting; nonconsulting fees from Vericel, Arthrex, and Stryker; royalties from Arthroscopy; and hospitality payments from Synthes GmbH. J.P.S. has received research support from Arthrex; financial or material support from Thieme; education payments from Elite Orthopedics; consulting fees from Medical Device Business Services, DePuy, Orthopedic Designs North America, Smith & Nephew, and Arthrex; nonconsulting fees from Synthes GmbH and Medical Device Business Services; and royalties from Thieme. R.M. has received research support from Cartiheal, Moximed, and Novocart. M.K. has received education payments from Elite Orthopedics and Arthrex; nonconsulting fees from Synthes GmbH; and honoraria from Synthes GmbH. J.L.C. has received research support from AO Trauma, Arthrex, Collagen Matrix, DePuy, Orthopaedic Trauma Association, Purina, Regenosine, and SITES Medical; financial or material support from Thieme; consulting fees from Arthrex and Trupanion; royalties from Arthrex, MTF Biologics, and Thieme; and is a board or committee member for MTF Biologics. 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.