Mayo Clinic, Department of Orthopedic Surgery, Rochester, MN 55905, USA.
Am J Sports Med. 2012 May;40(5):1053-9. doi: 10.1177/0363546511435780. Epub 2012 Feb 7.
Fresh-stored osteochondral allografts have been used successfully to resurface large chondral and osteochondral defects of the knee. However, there are limited data available for the return to athletic activity.
To review the rate of return to athletic activity after osteochondral allograft transplantation in the knee and to identify any potential risk factors for not returning to sport.
Case series; Level of evidence, 4.
Forty-three athletes were treated with fresh-stored osteochondral allograft transplantation for symptomatic large chondral or osteochondral defects of the knee from 2000 to 2010. The average age of the athletes (30 men, 13 women) was 32.9 years (range, 18-49 years). Patients were prospectively evaluated by International Knee Documentation Committee (IKDC), activities of daily living scale of the Knee Injury and Osteoarthritis Outcome Score (KOOS), Marx Activity Rating Scale, and Cincinnati Sports Activity Scale scores. A multivariable regression analysis was performed to identify potential risk factors for failure to return to sport at the preinjury level.
At an average 2.5-year follow-up, limited return to sport was possible in 38 of 43 athletes (88%), with full return to the preinjury level achieved in 34 of 43 athletes (79%). In these 34 athletes, time to return to sport was 9.6 ± 3.0 months. Age ≥25 years (P = .04) and preoperative duration of symptoms greater than 12 months (odds ratio, 37; P = .003) negatively affected the ability to return to sport. In the athletes who returned to their previous level of competition, IKDC (P < .001), KOOS (P = .02), and Marx Activity Rating Scale (P < .001) scores were all significantly greater than in those athletes who did not return to sport.
Osteochondral allograft transplantation in an athletic population for chondral and osteochondral defects in the knee allows for a high rate of return to sport. Risk factors for not returning to sport included age ≥25 years and preoperative duration of symptoms ≥12 months.
新鲜储存的同种异体骨软骨移植物已成功用于修复膝关节的大软骨和骨软骨缺损。然而，有关重返运动活动的数据有限。
回顾膝关节同种异体骨软骨移植后重返运动活动的比率，并确定任何不能重返运动的潜在风险因素。
病例系列；证据水平，4 级。
2000 年至 2010 年，43 名运动员因膝关节大软骨或骨软骨缺损接受新鲜储存同种异体骨软骨移植治疗。运动员的平均年龄（30 名男性，13 名女性）为 32.9 岁（18-49 岁）。通过国际膝关节文献委员会（IKDC）、膝关节损伤和骨关节炎结果评分（KOOS）的日常生活活动量表、Marx 活动评级量表和辛辛那提运动活动量表对患者进行前瞻性评估。进行多变量回归分析，以确定不能恢复到术前运动水平的潜在风险因素。
在平均 2.5 年的随访中，43 名运动员中有 38 名（88%）能够有限地重返运动，43 名运动员中有 34 名（79%）能够完全恢复到术前运动水平。在这 34 名运动员中，重返运动的时间为 9.6±3.0 个月。年龄≥25 岁（P=.04）和术前症状持续时间>12 个月（优势比，37；P=.003）对重返运动的能力有负面影响。在能够恢复到以前运动水平的运动员中，IKDC（P<.001）、KOOS（P=.02）和 Marx 活动评级量表（P<.001）评分均显著高于未重返运动的运动员。
同种异体骨软骨移植物移植治疗膝关节的软骨和骨软骨缺损可使运动员获得较高的重返运动的比率。不能重返运动的危险因素包括年龄≥25 岁和术前症状持续时间≥12 个月。
