Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York.
J Knee Surg. 2024 Nov;37(13):902-909. doi: 10.1055/a-2368-4253. Epub 2024 Jul 17.
Although several prior studies have described the outcomes of osteochondral allograft (OCA) transplantation for single osteochondral lesions, there is a paucity of comparative data on outcomes of single versus multiple OCA transplants. We aimed to describe the initial outcomes of single-plug versus multiple-plug knee OCA transplants at a minimum of 1 year of follow-up. We hypothesized that there would be no difference in patient-reported outcome measures (PROMs) between patients undergoing single-plug and multiple-plug OCA transplants at a minimum of 1 year of follow-up. We retrospectively reviewed the prospectively collected data of patients undergoing OCA transplantation for large (>2 cm) osteochondral defects of the knee. Thirty patients who underwent multiple-plug (2 + ) OCA transplants (either single surface using the snowman technique or multi-surface) were 1:1 age, sex, and body mass index (BMI) matched with 30 patients who underwent single-plug OCA transplants. PROMs, including the International Knee Documentation Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Score (KOOS) subscores, were obtained both preoperatively and at a minimum of 1 year postoperatively. Failure was defined as a revision OCA or conversion to unicompartmental knee arthroplasty (UKA) or total knee arthroplasty (TKA). The cohort comprised 30 females (31 affected left knees), with an average age of 37 ± 10.3 years and median follow-up of 2.0 years (interquartile range: 1.7-2.5 years). There was a significant increase in PROMs from the preoperative to the postoperative period for the entire cohort and the single-plug versus multiple-plug subgroups ( < 0.01). There was no difference between the groups with respect to the percentage of patients who achieved the minimal clinically important difference (MCID) for each PROM ( > 0.05). There were two failures, both in the single-plug group, with a mean time to failure of 3.5 years. There was no difference in the initial outcomes between patients undergoing single-plug versus multiple-plug OCA transplant at the short-term follow-up. LEVEL OF EVIDENCE:: Level IV, case series.
虽然已有几项先前的研究描述了骨软骨同种异体移植（OCA）治疗单个骨软骨病变的结果，但关于单发性与多发性 OCA 移植结果的比较数据却很少。我们旨在描述至少 1 年随访时单栓 versus 多栓膝关节 OCA 移植的初始结果。我们假设，在至少 1 年的随访中，接受单栓和多栓 OCA 移植的患者在患者报告的结果测量（PROM）方面没有差异。我们回顾性地分析了接受 OCA 移植治疗膝关节大（> 2cm）骨软骨缺损患者的前瞻性收集数据。30 例接受多栓（2+）OCA 移植（单表面采用雪人技术或多表面）的患者与 30 例接受单栓 OCA 移植的患者进行了 1:1 的年龄、性别和体重指数（BMI）匹配。在术前和至少 1 年的术后均获得了 PROM，包括国际膝关节文献委员会（IKDC）和膝关节损伤和骨关节炎结果评分（KOOS）子评分。失败的定义为翻修 OCA 或转为单髁膝关节置换术（UKA）或全膝关节置换术（TKA）。该队列包括 30 名女性（31 例左膝受影响），平均年龄 37±10.3 岁，中位随访时间为 2.0 年（四分位间距：1.7-2.5 年）。整个队列和单栓与多栓亚组的 PROM 均从术前到术后有显著增加（ < 0.01）。两组患者在每个 PROM 达到最小临床重要差异（MCID）的患者比例方面无差异（ > 0.05）。在单栓组中有 2 例失败，平均失败时间为 3.5 年。在短期随访中，接受单栓与多栓 OCA 移植的患者初始结果无差异。证据水平：Ⅳ级，病例系列。
