Osteochondral allograft knee transplantation relieves pain, improves function in athletes
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Patients who underwent osteochondral allograft knee transplantation had significant improvements in pain relief and functional outcomes, even when they did not return to sport, according to published results.
James L. Cook, DVM, PhD, and colleagues assessed 37 athletes who underwent primary large single-surface (n=17), multi-surface (n=4) or bipolar (n=16) osteochondral allograft knee transplantation for injury or overuse-related articular defects from June 2015 to March 2018. To be included in the study, athletes needed a preinjury Tegner level of 5 or greater, documented type and level of sport, and a minimum of 1-year follow-up outcomes, including return to sport data. Researchers assessed and compared patient characteristics, surgery type, Tegner level, return to sport, patient-reported outcome measures, compliance with rehabilitation, revisions and failures for statistically significant differences.
Results showed 68% of patients had returned to sport at final follow-up, with 68% returning to the same or higher level of sport compared with the highest preinjury level. Researchers found athletes had a median time to return to sport of 16 months and that elite unit military, competitive collegiate and competitive high school athletes returned at a significantly higher proportion compared with recreational athletes.
All patients had a significantly lower Tegner level at final follow-up compared with the highest preinjury Tegner level, according to results. Researchers noted a significant improvement in patient-reported outcome measures at final follow-up vs. preoperative levels, which reached or exceeded clinically meaningful differences. Results showed 5% of patients underwent osteochondral allograft revision and 5% of patients experienced failures that required total knee arthroplasty, all of whom were recreational athletes. Researchers documented noncompliance in 11% of patients. Patients who were noncompliant were 15.5 times more likely to be associated with failure or a need for revision compared with compliant patients, according to results.
“These initial results in a small population of athletes across the spectrum of level of sport suggest that osteochondral allograft transplantation using large shell grafts is a viable option to consider for treatment of complex knee injuries that are often ‘sports career-enders’ otherwise,” Cook told Healio Orthopedics. “While 90% of patients in this study reported significant and clinically meaningful improvements in function after surgery, only high-level athletes reported high levels of return to sport.”
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