D. Anderson (Rochester, US)
Presenter Of 1 Presentation
23.2.9 - Computed tomography parameters following osteochondral allograft transplantation do not correlate with patient reported outcomes
Abstract
Purpose
Prior studies have shown favorable and durable clinical outcomes following osteochondral allograft (OCA) transplantation to treat osteochondral defects; however, there is not an established imaging modality to evaluate tissue healing relative to clinical outcomes. The purpose of this study was to define parameters for OCA bone healing using computed tomography (CT) and to assess for correlation with patient reported outcomes (PROs).
Methods and Materials
CT scans were obtained 5.8 ± 1.9 months post-operatively for 60 patients who underwent OCA transplantation for articular cartilage defects of the knee. CT parameters (Figure 1) were summarized for each patient relative to the cohort using Mahalanobis distances, which were further assessed for covariation with demographic and surgical variables. Patient reported outcomes were collected pre-operatively and at post-operative intervals. Structural equation modeling (SEM) was employed to assess for correlation of CT parameters with PROs closest in time to CT, and with PRO change from pre-operative baseline to final follow-up, adjusted for duration.
Results
When scaled by covariance among CT parameters, the collection of CT scans was distributed according to multivariate normality and without outliers. Variance in CT parameters was independent of age, gender, BMI, prior surgery, number of grafts, lesion size, and location. No significant correlation (p>0.12 across all comparisons) was identified in any combination of CT parameter and most proximal PRO or change in PRO (Table 1). There was, however, a uniformly positive association between host bone density and change in PRO, independent of demographic and surgical factors.
Conclusion
Computed tomography has potential to measure tissue-level changes following OCA transplantation. The identified CT parameters were normally distributed within the study population and may be useful in evaluating bone healing and incorporation in individual patients. These metrics collected from a single post-operative CT scan, however, do not correlate with clinical outcomes at 6-months or longitudinal follow-up.