16.3.10 - Long-Term Outcomes of Osteochondral Allograft Transplantation to the Humeral Head
- A. Yanke (Chicago, US)
- J. Kaiser (Chicago, US)
- E. Haunschild (Chicago, US)
- N. Condron (Chicago, US)
- B. Bodendorfer (Chicago, US)
- K. Wagner (Chicago, US)
- Z. Meeker (Chicago, US)
- A. Yanke (Chicago, US)
- A. Romeo (Downers Grove, US)
- B. Cole (Chicago, US)
Abstract
Purpose
To evaluate survivorship, patient satisfaction, and long-term functional outcomes of humeral head osteochondral allograft (OCA) transplantation in patients with isolated focal chondral defects.
Methods and Materials
A registry of consecutive patients undergoing humeral head OCA transplantation between 2004 and 2012 was retrospectively reviewed. Treatment failure was defined as conversion to total shoulder arthroplasty (TSA). Patients completed Simple Shoulder Test (SST), American Shoulder and Elbow Surgeons Shoulder Score (ASES), and Short Form 12 (SF-12) Physical and Mental outcome assessments. Patient satisfaction and sport activity outcomes were also assessed. Postoperative outcomes were compared to baseline scores using Student’s t-tests with statistical significance defined as P<0.05.
Results
20 patients were identified, of which 13 (65%) had completed follow-up and were included in the analysis. Five patients (38.6%) failed treatment and underwent TSA at an average 3.91 ± 4.25 years (range 0.97-11.0) after index surgery. The average follow-up of the remaining eight patients (4 females, 4 males, mean age 26.8 ± 10.2 years) was 12.0 ± 3.1 years (range 7.6-15.7 years). Mean scores of all outcome assessments were higher at final follow-up than at baseline, but the difference was significant only in SST scores (Table 1). Patient satisfaction varied, with four patients reporting extreme satisfaction, one reporting moderate satisfaction, two reporting somewhat satisfaction, and one reporting no satisfaction. Only three of the eight patients were able to return to sport, two at the same level of competition and one at a lower level of competition.
Conclusion
The results of this case series suggest that the reported short and mid-term outcome improvements of humeral head OCA transplantation diminish at long-term time points. Moreover, athletes should be counseled on sport activity outcome probabilities. Despite these limitations, patient satisfaction rates with regards to long-term outcomes are generally favorable.