• Am J Sports Med · Mar 2015

    Fresh osteochondral allograft transplantation for bipolar reciprocal osteochondral lesions of the knee.

    • Gokhan Meric, Guilherme C Gracitelli, Simon Görtz, Allison J De Young, and William D Bugbee.
    • Shiley Center for Orthopaedic Research and Education, Scripps Clinic, La Jolla, California, USA Department of Orthopaedic Surgery, Balikesir University, Balikesir, Turkey.
    • Am J Sports Med. 2015 Mar 1; 43 (3): 709-14.

    BackgroundOsteochondral allograft (OCA) transplantation is an effective treatment option for chondral and osteochondral defects of the knee.HypothesisPatients treated with OCAs for reciprocal bipolar lesions of the knee would demonstrate significant clinical improvement.Study DesignCase series; Level of evidence, 4.MethodsBetween 1983 and 2010, OCAs were implanted for bipolar chondral lesions in 46 patients (48 knees). The 21 male and 25 female patients averaged 40 years of age (range, 15-66 years). Thirty-four lesions were tibiofemoral, and 14 were patellofemoral. Forty-two knees (88%) had undergone a mean of 3.4 previous surgeries (range, 1-8). The mean allograft area was 19.2 cm(2). Clinical evaluation included the modified Merle d'Aubigné-Postel (18-point), International Knee Documentation Committee (IKDC) pain and function, and Knee Society function (KS-F) scores. Further surgeries on the operative joint were documented.ResultsSurvivorship of the bipolar OCA was 64.1% at 5 years. Thirty knees underwent further surgery; 22 knees (46%) were considered failures (3 OCA revisions, 14 total knee arthroplasties, 2 unicondylar arthroplasties, 2 arthrodeses, and 1 patellectomy). Among patients whose OCA was still in situ at follow-up, the mean follow-up was 7 years (range, 2.0-19.7 years). The mean 18-point score improved from 12.1 to 16.1; 88% (23/26 knees) of surviving allografts scored ≥15. The mean IKDC pain score improved from 7.5 to 4.7, and the mean IKDC function score improved from 3.4 to 7.0. The mean KS-F score improved from 70.5 to 84.1.ConclusionOsteochondral allograft transplantation is a useful salvage treatment option for reciprocal bipolar cartilage lesions of the knee. High reoperation and failure rates were observed, but patients with surviving allografts showed significant clinical improvement.© 2015 The Author(s).

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