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Clinical Outcomes and Failure Rates of Osteochondral Allograft Transplantation in the Knee: A Systematic Review
Author(s):
Familiari F. (Italien)
,
Familiari F. (Italien)
Affiliations:
Chahla J. (Vereinigte Staaten von Amerika)
,
Chahla J. (Vereinigte Staaten von Amerika)
Affiliations:
Moatshe G. (Vereinigte Staaten von Amerika)
,
Moatshe G. (Vereinigte Staaten von Amerika)
Affiliations:
Cinque M. (Vereinigte Staaten von Amerika)
,
Cinque M. (Vereinigte Staaten von Amerika)
Affiliations:
Olesen M. (Dänemark)
,
Olesen M. (Dänemark)
Affiliations:
Godin J. (Vereinigte Staaten von Amerika)
,
Godin J. (Vereinigte Staaten von Amerika)
Affiliations:
LaPrade R. (Vereinigte Staaten von Amerika)
LaPrade R. (Vereinigte Staaten von Amerika)
Affiliations:
ESSKA Academy. FAMILIARI F. 05/09/18; 209325; P03-209 Topic: Open Surgery
Dr. Filippo FAMILIARI
Dr. Filippo FAMILIARI
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Abstract
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Objectives: To perform a systematic review of clinical outcomes and failure rates after OCA transplantation in the knee at a minimum 2 years' average follow-up.

Methods: A systematic review of the literature regarding the existing evidence for clinical outcomes and failure rates of OCA transplantation in the knee joint was performed using the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, PubMed, and MEDLINE from studies published between 1980 to 2017. Inclusion criteria were as follows: clinical outcomes and failure rates of OCA for the treatment of chondral defects in the knee joint, English language, average follow-up of 2 years and minimum follow-up of 18 months, minimum study size of twenty patients and human studies. The methodological quality of each study was assessed using a modified version of the Coleman methodology score (mCMS).

Results: The systematic search identified 19 studies with a total of 1036 patients. The mean 5-year survival across the studies included in this review was 86.7% (range, 64.1%-100%), while the mean 10-year survival averaged 78.7% (range, 39%-93%). Long-term mean survival was 72.8% at 15 years (range, 55.8%-84%) and 67.5% at 20 years (range, 66-69%).
The weighted mean patient age was 31.5 years (range, 10-82 years) and the weighted mean follow-up was 8.7 years (range, 2-32 years). The following outcomes scores showed significant improvement from pre-operative to post-operative status: d'Aubigné-Postel, International Knee Documentation Committee, Knee Society-Function, and Lysholm scores. The weighted mean reoperation rate was 30.2% (range, 0-63%). The weighted mean failure rate was 18.2% (range, 0-31%). Of note, revision cases, patellar OCAs and OCAs for bipolar lesions demonstrated worse survival rates.

Conclusions: Improved patient reported outcomes can be expected after osteochondral allograft transplantation with survival rates of 78.7% at 10 years. Revision cases, patellar lesions, bipolar lesion were associated with worse survival rates; therefore, utilization of the most appropriate index cartilage restoration procedure and proper patient selection are key to improving results.

Keywords:
osteochondral allograft transplantation; knee; cartilage; repair
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