Purpose
To determine clinical results after combined femoral osteochondral allograft and meniscus
transplantation.
Methods
Thirty-two patients with a minimum 2-year follow-up were identified who had previously
undergone combined meniscus allograft transplantation and fresh osteochondral allograft
transplantation. Demographic and intraoperative data, including condylar defect size,
as well as the preoperative and postoperative International Knee Documentation Committee
(IKDC) score, Short Form 12 score, Knee Injury and Osteoarthritis Outcome Score (KOOS),
and Lysholm score, were recorded. Paired tests and regression analysis were used,
and an α value of .05 was set as significant with Bonferroni correction used in the
case of multiple comparisons.
Results
The mean follow-up period was 4.2 years (range, 2 to 11 years). The mean condylar
defect size was 4.7 ± 2.0 cm2 at the time of the index procedure. Lysholm scores, IKDC scores, and all KOOS subdomains
showed significant improvement from preoperatively to postoperatively (P < .001). Patients with condylar defects of less than 4 cm2 had a significantly greater increase in the preoperative versus postoperative IKDC
score (P = .010), Lysholm score (P = .018), and KOOS (P = .016) than those with condylar defects greater than 4 cm2. Femoral condyle defect size was also significantly inversely correlated with the
postoperative IKDC score (P = .015), KOOS (P = .003), and Lysholm score (P = .010). The rate of patient satisfaction with the procedure was 82%.
Conclusions
Patients undergoing combined meniscus allograft and femoral osteochondral allograft
transplantation showed improved functional scores after surgery. The postoperative
scores, however, indicated residual knee dysfunction, and the reoperation rate was
high. There was an inverse association between postoperative functional scores and
the size of the condylar defect.
Level of Evidence
Level IV, therapeutic case series.
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Article info
Publication history
Published online: May 06, 2014
Accepted:
March 11,
2014
Received:
August 28,
2013
Footnotes
The authors report the following potential conflict of interest or source of funding: B.J.C. receives support from Arthroscopy Association of North America, Genzyme, Arthrex, Zimmer, Carticept, Regentis, DJ Orthopedics, Johnson & Johnson, Major League Baseball, Musculoskeletal Transplant Foundation, Orthopedic Research and Education Foundation, NIH/MIMAS, Arthrosurface, Medipost. Legal expert for medical malpractice defense and third-party liability cases (personal injury and product liability).
Note: To access the supplementary table accompanying this report, visit the December issue of Arthroscopy at www.arthroscopyjournal.org.
Identification
Copyright
© 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
