2015 ISAKOS Biennial Congress ePoster #1516

Mid-Term Follow-Up of the Use of Massive Frozen Tibial Osteochondral Allografts for Posttraumatic Tibial Plateau Defects

Juan Ignacio Erquicia, MD, Sant Pere De Ribes SPAIN
Pablo E. Gelber, MD, PhD, Barcelona SPAIN
Marc Tey, MD, Barcelona SPAIN
Xavier Pelfort, PhD, Igualada, Barcelona SPAIN
Joan Carles Monllau, MD, PhD, Prof., Esplugues de Llobregat, Barcelona SPAIN
Institut Universitari Dexeus-Quiron, Barcelona, Barcelona, SPAIN

FDA Status Not Applicable

Summary: Transplantation of frozen osteochondral grafting for the treatment of tibial plateau posttraumatic sequelae seems a valid alternative in the short and medium term in the young patient

Abstract:

Introduction

Intra-articular fracture of the tibial plateau has a risk factor for post traumatic osteoarthritis.Large focal lesions of the tibial plateau resulting from fracture offer fewer management alternatives when compared with their femoral condylar counterparts. Techniques such as mosaicplasty or autologous chondrocyte transplantation have not been as positive for patients with tibial plateau
lesions as it has been for patients with femoral condylar lesions.Other alternative, is the use of osteochondral transplantation
Objectives: Analyse clinical and radiographic results in patients which were treated their post-traumatic
tibial defects with frozen osteochondral allograft transplantation. The working hypothesis was that its
use would be a valuable tool that could improve clinically while avoiding prosthetic joint replacement
techniques.

Methods

We retrospectively analyzed 18 patients transplanted with frozen osteochondral graft tibial plateau. Only those who had a minimum follow-up of 24 months were included. Were assessed with HSS score, Tegner and VAS for pain. Were analyzed radiographically with telemetry and Rosenberg projection. We analyzed
graft survival by Kaplan-Meier test.

Results

15 patients were included (3 failed), with mean age of 39 years and mean follow up of 73 months (25-125). 13 lateral plateau and 2 medial plateau were transplanted. In 8 cases, meniscus were included.
Realignment osteotomy was performed in 5 cases. Graft survival was 78,8% to 10 years. In all the 15 cases, HHS was more than 70, with no difference between who underwent osteotomy or among those who included the meniscus. In 9 cases there weren´t or were mild degenerative changes.

Conclusions

Transplantation of frozen osteochondral grafting for the treatment of tibial plateau posttraumatic sequelae seems a valid alternative in the short and medium term in the young patient. While functional and radiographic results are good, their ability to delay partial or total knee arthroplasty still need longer follow up and a larger number of cases.