2023 ISAKOS Biennial Congress ePoster
Subsequent Surgeries Following Osteochondral Allograft and Osteochondral Autograft at up to Ten Years: An Analysis of over 2,000 Patients
Patrick J Burroughs, MD, Washington D.C. UNITED STATES
Joseph B Kahan, MD, New Haven UNITED STATES
Jay Moran, BS, New Haven UNITED STATES
Stephen M Gillinov, AB, New Haven, CT UNITED STATES
Peter Y Joo, MD, MPH, New Haven UNITED STATES
Christopher Schneble, MD, New Haven, Connecticut UNITED STATES
Harold Gregory Moore, MD, Dallas UNITED STATES
Jonathan Grauer, New Haven, CT UNITED STATES
Michael J. Medvecky, MD UNITED STATES
Yale School of Medicine, New Haven, Connecticut, UNITED STATES
FDA Status Not Applicable
Summary
There were similarly high rates of subsequent surgery on five-year survival analysis between the osteochondral allograft and autograft cohorts.
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Abstract
Objectives:
Osteochondral allograft transplantation (OCA) and osteochondral autograft transfer (OAT) replace damaged cartilage with a plug of bone and overlying articular cartilage; however, there is limited research on the survival of these two differing osteoarticular grafting procedures.
We hypothesized that patients undergoing osteochondral allograft transplant would have a higher rate of subsequent surgeries over five years when compared to patients who underwent osteochondral autograft transfer.
Methods
The 2010-2018 PearlDiver Mariner administrative database was used to identify patients 10 to 59 years old who underwent osteochondral allograft (OCA) or osteochondral autograft transfer (OAT). All patients in the dataset meeting these criteria were assessed for subsequent knee surgeries, defined by the occurrence of a subsequent osteochondral (OCA or OAT) procedure or any type of knee arthroplasty for the duration of the time they were included in the dataset (maximum of ten years).
Analyses were performed for the total population and those with allograft versus autograft (compared with Fisher’s exact test). Five-year Kaplan-Meier survival curves for operation-free survival were compared using a Mantel-Cox Log-rank test. Statistical significance was set at p<0.05.
Results
In total, 1,631 patients were identified who underwent OCA (34.5 ± 12.1 years old, 51.6% females) and 967 patients were identified who underwent OAT (32.1 ± 12.9 years old, 51.0% females).
Both OCA and OAT had similarly high rates of subsequent knee surgeries, with no statistical differences between subsequent surgery rates of allograft and autograft patients. Kaplan-Meier survival curves comparing osteochondral allograft versus autograft transplant operation-free survival at five years were not significantly different (88.0% vs. 89.5%, p=0.235).
Conclusions
Osteochondral grafting procedures carry a relatively high rate of secondary surgery, which increases with time. Noting that there may be selection bias and differing indications between the osteochondral allograft and autograft cohorts, there were similarly high rates of subsequent surgery on five-year survival analysis.