May 13, 2015
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Osteochondral autograft transplantation may offer higher rate of return to pre-injury athletics

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CHICAGO — Among patients who underwent cartilage repair of the knee, osteochondral autograft transplantation enabled a much higher rate of return to pre-injury athletics, according to results presented at the International Cartilage Repair Society Annual Meeting.

“Osteochondral autograft transfer offers a significantly higher return rate to pre-injury athletics,” Aaron J. Krych, MD, said in his presentation here. “We also found that this allowed for the fastest return to sport, but overall cartilage repair in athletes allowed for a reasonable level of return to recreational sports at midterm follow-up.”

Krych and colleagues performed a literature review for studies with return-to-sports outcomes after microfracture, osteochondral autograft transplantation, osteochondral allograft transplantation and autologous cartilage implantation among patients with International Cartilage Repair Society (ICRS) grade III or IV chondral defects of the knee.

Results showed 75.9% of athletes returned to sport, with the highest rates of return observed among patients who underwent osteochondral autograft transplantation and osteochondral allograft transplantation. Overall, osteochondral autograft transplantation showed a significantly higher rate of return to sport vs. autologous cartilage implantation (ACI), biologics and microfracture.

The researchers also found osteochondral autograft transplantation had the fastest time to patients’ return to sports.

“We looked at time for clearance to return to sport and we found that the autograft transfer group had a significantly faster return to sport — just over 5 months compared with 9 months and 1 month for the other modalities,” Krych said.

KOOS sports scores among all groups significantly improved at the 2-year and 5-year outcomes, according to Krych.
“Specifically, when looking at the 2-year follow up data, osteochondral autograft transfer had significantly higher scores than all the other groups,” Krych said.

He added the autograft and allograft osteochondral groups had higher 5-year scores vs. microfracture and ACI.

Tegner activity scores also significantly improved at the 2-year and 5-year mark, with scores declining significantly in the microfracture and ACI groups, according to the researchers. – by Casey Tingle

Reference:

King AH, et al. Return to sport following cartilage repair in the knee. Presented at: International Cartilage Repair Society Annual Meeting. May 8-11, 2015; Chicago.

Disclosure: Krych reports he is a paid consultant for Arthrex and received research support from the Arthritis Foundation and Histogenics.