High survival rate found with osteochondral allograft transplantation

BOSTON — Following osteochondral allograft transplantation, there was a high survival rate at an average of 5 years and arthroscopic debridement was the most common reoperation, according to results presented here.

“The take home points are that [there was] 86% survivorship and 39% reoperation rate at 5 years,” Brian J. Cole, MD, MBA, said in his presentation. “Arthroscopic debridement was most commonly performed and 82% of those that underwent debridement actually improved after the debridement, but 18% went on to failure.”

In a retrospective review of 171 patients who underwent osteochondral allograft transplantation, Cole and his colleagues collected radiographs and patient-reported outcomes.

Brian J. Cole

“The important thing is to look at the definition of failure which included revision of the osteochondral allograft [and] conversion to arthroplasty, and we were also interested in how the graft looked at the time of reoperation and what role that played to their ongoing or recurring symptoms,” Cole said.

Results showed 96% of patients had prior surgery, and there was an overall reoperation rate of 39% at an average of 2.5 years. Cole noted 32% of patients required additional reoperations, of which 59% occurred within the first 2 years of osteochondral allograft transplant. Results showed failure occurred in 16.8% of patients at an average of 5 years.

“One of the independent variables was the number of previous surgeries, which is predictive of reoperation and failure,” Cole said. “What was interesting was that concomitant meniscal allograft transplantation was not an independent risk factor for reoperation or failure.”

Results showed significant improvements in patient-reported outcomes, with inferior outcomes found among patients who underwent reoperations. – by Casey Tingle

Reference:

Cole BJ, et al. Paper #SS-55. Presented at: Arthroscopy Association of North America Annual Meeting; April 14-16, 2016; Boston.

Disclosure: Cole reports he receives research support from Aesculap/B. Braun, Arthrex Inc., Cytori, Medipost, NIH (NIAMS & NICHD) and Zimmer; receives IP royalties from Arthrex Inc., DJ Orthopaedics and Elsevier Publishing; is a paid consultant for Arthrex Inc., Regentis and Zimmer; receives other financial or material support from Athletico, Ossur, Smith & Nephew and Tornier; has stock or stock options in Carticept and Regentis; and receives publishing royalties, financial or material support from Saunders/Mosby-Elsevier and SLACK Incorporated.