Enrollment in a Behavioral Health Program Positively Impacts 2-Year Cumulative Survival Rates in Osteochondral Allograft Transplant Patients.

Emerging evidence suggests that patients' behavioral health may influence outcomes after osteochondral allograft transplantation (OCAT). A comprehensive behavioral health program (BHP) including preoperative screening and education, and postoperative counseling and support, led by a health behavior psychologist was implemented for patients considering OCAT. We hypothesized that patients undergoing knee OCAT and enrolled in the BHP would have a significantly higher 2-year graft survival rate than those not enrolled. Prospectively collected data for patients undergoing knee OCAT enrolled in the lifelong outcomes registry were analyzed. Based on the timing of implementation of a comprehensive BHP to provide preoperative screening and education followed by postoperative counseling and support, BHP and no-BHP cohorts were compared. Treatment failure was defined as the need for either OCAT revision surgery or knee arthroplasty. The Kaplan-Meier method using log-rank tests compared cumulative survival rates. Multivariable Cox regression analysis was used to determine the effects of confounding variables on the influence of BHP enrollment on graft survival. A total of 301 patients were analyzed (no-BHP = 220 and BHP = 81). At 2-year follow-up, a significantly lower cumulative graft survival rate was observed for patients not enrolled in the BHP (68.2 vs. 91.4%;

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Déclaration de conflit d'intérêts

The author group reports the following interests:J.W. is an employee of Arthrex, Inc.K.R. has no conflicts to report.R.S. has no conflicts to report.J.P.S. reports the following:Arthrex, Inc: Paid consultant; Research support, DePuy, A Johnson & Johnson Company: Paid consultant; Journal of Knee Surgery: Editorial or governing board; National Institutes of Health (NIAMS & NICHD): Research support; Orthopedic Designs North America: Paid consultant; Smith & Nephew: Paid consultant; Thieme: Publishing royalties, financial or material support; U.S. Department of Defense: Research supportC.C. has no conflict to report.A.S. receives IP royalties from the Musculoskeletal Transplant Foundation.C.N. reports the following:AAOS: Board or committee member; American Orthopaedic Society for Sports Medicine: Board or committee member; AO Foundation: Other financial or material support; Arthrex, Inc: Paid presenter or speaker; Arthroscopy: Editorial or governing board; Publishing royalties, financial or material support; Arthroscopy Association of North America: Board or committee member; Guidepoint Consulting: Paid consultant; Vericel, Inc.: Paid presenter or speakerJ.L.C. reports the following:AANA: Research support; AO Trauma: Research support; Advanced Research Projects Agency for Health: Research support; Arthrex, Inc: IP royalties; Paid consultant; Research support; Boehringer Ingelheim: Paid consultant; Collagen Matrix Inc: Paid consultant; Research support; GE Healthcare: Research support; Journal of Knee Surgery: Editorial or governing board; Midwest Transplant Network: Board or committee member; Musculoskeletal Transplant Foundation/MTF Biologics: Board or committee member; IP royalties; Research support; National Institutes of Health (NIAMS & NICHD): Research support; OREF: Research support; PCORI: Research support; Thieme: Publishing royalties, financial or material support; Trupanion: Paid consultant; U.S. Department of Defense: Research support.