April 2018

Transplantation may be effective for some knee cartilage repair

Research presented March 10 at the American Orthopaedic Society for Sports Medicine’s (AOSSM) Specialty Day in New Orleans has shown that osteochondral allograft transplantation (OCA) is a valuable and successful approach for isolated femoral condyle lesions, which account for 75% of the cartilage repair procedures performed in the knee joint. Lead author Luís E. Tírico, MD, with the University of São Paulo in Brazil, stated, “Our study demonstrated that the modern OCA transplantation technique, which utilizes thin, dowel type grafts, was very effective in treating patients with femoral condyle cartilage lesions. In 200 cases, we noted an 89% satisfaction rate with those treated by this method, along with significant improvements in clinical scores and a low graft failure rate.”

The study is the largest reported cohort of isolated femoral condyle lesions treated with the modern, dowel technique for OCA transplantation, A total of 187 patients (200 knees) underwent OCA transplantation between June 1999 and August 2014.

At an average of 6.7 years of follow-up (minimum 2 years), International Knee Documentation Committee (IKDC) total scores improved from 43.7 to 76.2 on average, and Knee injury and Osteoarthritis Outcome Score (KOOS) for pain improved from 66.5 to 85.3, and 74.5 to 91.1 for activities of daily living. Further surgery was required in 52 knees (26%), of which 16 (8%) were considered failures, as defined by removal or revision of the allograft. “These results appear to be equal or superior to any other cartilage repair procedure for the treatment of femoral condyle lesions and leads us to consider whether fresh OCA should be viewed as the current gold standard in cartilage repair for focal femoral condyle lesions,” Tírico stated.

Source:

Tirico LE, McCauley JC, Pulido P, Bugbee W. modern osteochondral allograft transplantation: the “gold standard” for femoral condyle cartilage repair? Presented at: American Orthopaedic Society for Sports Medicine’s Specialty Day; March 10, 2018; New Orleans, LA. https://www.sportsmed.org/ aossmimis/Members/Downloads/MeetingResources/SD2018/Abstract1.pdf.

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