2015 ISAKOS Biennial Congress ePoster #1518
Fresh Osteochondral Allograft Transplantation for Isolated Patellar Cartilage Injury
Guilherme Gracitelli, MD, La Jolla, CA UNITED STATES
Gokhan Meric, Assoc. Prof., Istanbul TURKEY
Pamela Pulido, MD, La Jolla, CA UNITED STATES
Simon Görtz, MD, Phoenix, AZ UNITED STATES
Allison De Young, MPA, PA-C, La Jolla, CA UNITED STATES
William Bugbee, MD, La Jolla, CA UNITED STATES
Shiley Center for Orthopaedic Research and Education, Scripps Clinic, La Jolla, California, USA
FDA Status Cleared
Summary: OCA transplantation was successful as a salvage treatment procedure for cartilage injuries of the patella.
The treatment of patellofemoral cartilage injuries can be challenging. Osteochondral allograft (OCA) transplantation has been used as a treatment option for a range of cartilage pathology.
The purpose of this study was to evaluate functional outcomes and survivorship of the grafts among patients who underwent OCA for patellar cartilage injuries.
Study Design: Retrospective cohort
An IRB-approved OCA database was used to identify 27 patients (28 knees) who underwent isolated OCA transplantation of the patella between 1983 and 2010. All patients had minimum 2 years follow-up. The mean age of the patients was 33.6 years (range, 14-64 years); 54% were female. Twenty-six (92.9%) knees had previous surgery (mean 3.2 procedures, range 1-10). The mean allograft area was 10.1 cm² (range, 4.0-18.0 cm²). Patients returned for clinical evaluation or were contacted via telephone for follow-up. The number and type of reoperations were assessed. Any reoperation resulting in removal of the allograft was considered a failure of the OCA transplantation. Patients were evaluated pre- and postoperatively using the modified Merle d'Aubigné-Postel (18-point) scale, the International Knee Documentation Committee (IKDC) pain and function scores, and the Knee Society function (KS-F) score. Patient satisfaction was assessed at latest follow-up.
Seventeen of the 28 knees (60.7%) had further surgery following the OCA transplantation. Eight of the 28 knees (28.6%) were considered OCA failures (4 conversions to total knee arthroplasty, 2 conversions to patellofemoral knee arthroplasty, 1 revision OCA, 1 patellectomy). Patellar allografting survivorship was 78.1% at 5 and 10 years, and 55.8% at 15 years. Among the 20 knees (71%) with grafts in situ, the mean follow-up duration was 9.7 years (range 1.8-30.1 years). Pain and function improved from the preoperative visit to latest follow-up. Eighty-nine percent of patients were extremely satisfied or satisfied with the results of the OCA transplantation.
OCA transplantation was successful as a salvage treatment procedure for cartilage injuries of the patella.
Key Terms: Patella; cartilage; osteochondral allograft; osteochondral defect; osteochondral transplantation