F. Coxe (New York, US)
HSS Sports MedicinePresenter Of 1 Presentation
23.2.5 - Elliptical, Stacked, and Single Osteochondral Allograft Transplantation for Large Knee Chondral Defects: One-Year MRI Outcomes
Abstract
Purpose
Osteochondral allograft transplantation (OCA) is a proven cartilage restoration procedure for patients with large chondral defects. However, elongated condylar lesions pose a challenge for dowel OCA in restoring articular surface congruity. Recently, instrumentation to harvest a single, elliptical allograft (BioUni, Arthrex) has been developed for treating ovoid lesions without requiring an adjacent-plug (stacked or snowman) technique (Figure 1). The purpose of this study was to compare 1-year MRI outcomes of patients treated with elliptical, stacked, or single OCA using the Osteochondral Allograft MRI Scoring System (OCAMRISS) and percent osseous integration.
Methods and Materials
A retrospective review on patients treated from 2000 to 2018 with OCA for condylar defects of the knee was conducted. Inclusion criteria included those followed prospectively with a MRI at ~1 year after surgery. OCAMRISS and osseous integration scores (0-25%; 26-50%; 51-75%; 76%-100%) were graded by a musculoskeletal radiologist blinded to the outcomes. Comparisons of demographics and MRI scores were performed with the ANOVA.
Results
A total of 48 knees (mean age, 35.8 years; 70% male) met the inclusion criteria and were treated with either elliptical (n=19), stacked (n=19), or single (n=19) OCA. Mean time to post-operative MRI was 10.7, 11.1, and 12.4 months, respectively (p=0.17). There were no significant differences in demographics or number of prior ipsilateral knee surgeries among groups. Bone, cartilage, ancillary, and total OCAMRISS scores were not significantly different between groups (Table 1). A trend towards a higher percentage of osseous integration (single>stacked>elliptical) was noted which correlated with less transplanted allograft bone, however, these differences were not significant (p=0.15).
Conclusion
One-year OCAMRISS and osseous integration scores did not differ among patients treated with elliptical, stacked, or single OCA. Further investigation is needed to explore potential differences in clinical outcomes and long-term osseous integration between elliptical and stacked OCA for the treatment of elongated condylar defects of the knee.