Outcomes Associated with Osteochondral Allografting for Large Cartilage Defects in Knees with or without Co-morbidities

Abstract

To determine preoperative variables that may influence outcomes after osteochondral allograft transplantation for large cartilage defects in the knee. A retrospective review of 36 patients who underwent osteochondral allograft transplantation for grade IV cartilage defects in knees with minimum 12-month (range 13-53, mean=28) follow-up. Variables evaluated included: smoking, workers compensation, BMI, pre-injury activity level (high level athlete, recreational athlete, active non-athlete, minimal activity, sedentary), number and type of co-morbidities in the knee (meniscal, ligament, and/or other cartilage pathology), lesion location (medial femoral condyle, lateral femoral condyle or multiple), number of grafts (1, 2 or >2) and patients who underwent OCA transplantation related revision surgery. Preoperative and postoperative VAS pain scores were the primary outcome measure. Success was defined as a VAS score of 0 or improvement in score (decrease) of 2 or more by final follow-up. Statistically significant (p The study population was 18 males and 18 females, with an average age of 35.3 years (14-61). Twenty-six patients (72%) had successful outcomes. Twenty-six patients had co-morbidities (1-4, median = 2), with 69% of these patients achieving a successful outcome. 80% of patients with no co-morbidities achieved a successful outcome, but this difference was not statistically significant (p=0.42). Active patients (HLA, REC, ACT) were significantly (p=0.047) and 3.8 times more likely to have a successful outcome than minimally active or sedentary patients. Patients with BMI Osteochondral allograft transplantation can be a successful treatment for cartilage defects in the knee, with patients without co-morbidities performing better and patients who are more active preoperatively significantly more likely to have a successful outcome.