Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA; Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, MO, USA.
Department of Orthopaedic Surgery, University of Missouri, Columbia, MO, USA; Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, MO, USA.
Knee. 2024 Jan;46:128-135. doi: 10.1016/j.knee.2023.12.002. Epub 2023 Dec 20.
Knee osteochondral allograft transplantation (OCAT) has been associated with good short- to mid-term outcomes, however, treatment failures occur more frequently than desired. This study used data from a lifelong outcomes registry to analyze knee OCAT treatment failure rates, variables associated with knee OCAT treatment failures, and outcomes after revision or arthroplasty surgery for knee OCAT treatment failures.
Patient outcomes were followed after knee OCAT performed using standard preservation (SP) or Missouri Osteochondral Preservation System (MOPS®) allografts. The study population consisted of patients undergoing primary OCAT with ≥ 2-year follow-up. For comparisons, the treatment failure population was defined by patients in the study population with documented treatment failure (revision or arthroplasty) with ≥ 2-year follow-up after failure. Functional graft survival was defined as no further need for revision surgery after primary or revision OCAT.
A total of 262 patients (n = 136 males; 51.9%) were analyzed. SP grafts were used for 59 cases and MOPS grafts were used for 203 cases. Treatment failure was documented in 61 cases (23.3%). MOPS grafts were 3.3 times more likely to be associated with functional graft survival. SP grafts, older patient age, higher BMI, tibiofemoral bipolar OCAT and non-adherence to the postoperative rehabilitation protocol were significantly associated with treatment failure.
Knee OCAT resulted in functional graft survival at short- to mid-term follow-up in the majority (70-88%) of cases. In addition, revision of primary OCAT resulted in functional graft survival for at least 2 years after revision surgery in the majority (66%) of patients.
2, prospective cohort study.
膝关节骨软骨同种异体移植（OCAT）具有良好的短期至中期疗效，但治疗失败的情况比预期更为常见。本研究使用终身疗效登记处的数据，分析膝关节 OCAT 治疗失败率、与膝关节 OCAT 治疗失败相关的变量，以及膝关节 OCAT 治疗失败后翻修或关节置换手术的结果。
采用标准保存（SP）或密苏里州骨软骨保存系统（MOPS®）同种异体移植物进行膝关节 OCAT 后，对患者进行随访。研究人群为接受初次 OCAT 且随访时间≥2 年的患者。为进行比较，将治疗失败人群定义为研究人群中记录到治疗失败（翻修或关节置换）且在失败后随访时间≥2 年的患者。功能移植物存活率定义为初次或翻修 OCAT 后无需进一步翻修手术。
共分析了 262 例患者（n=136 例男性；51.9%）。59 例使用 SP 移植物，203 例使用 MOPS 移植物。61 例（23.3%）记录到治疗失败。MOPS 移植物与功能移植物存活率相关的可能性是 SP 移植物的 3.3 倍。SP 移植物、患者年龄较大、BMI 较高、髌股关节双极 OCAT 和不遵守术后康复方案与治疗失败显著相关。
膝关节 OCAT 在短期至中期随访中，大多数（70-88%）病例实现了功能移植物存活率。此外，在大多数（66%）患者中，初次 OCAT 的翻修可在翻修手术后至少 2 年内实现功能移植物存活率。
2，前瞻性队列研究。
