Fresh osteochondral allograft transplantation for knee full-thickness articular cartilage lesions using femoral head of living donors: short-term results.

Autor: Soubih HO; Orthopedic Department, Faculty of Medicine, Ain Shams University, Cairo Governorate, Egypt. heshamossama826@gmail.com., Al-Saed AM; Orthopedic Department, Faculty of Medicine, Ain Shams University, Cairo Governorate, Egypt., Ghazaly SAE; Orthopedic Department, Faculty of Medicine, Ain Shams University, Cairo Governorate, Egypt., Sobhy MH; Orthopedic Department, Faculty of Medicine, Ain Shams University, Cairo Governorate, Egypt., Kamel ME; Orthopedic Department, Faculty of Medicine, Ain Shams University, Cairo Governorate, Egypt., Ebied WF; Orthopedic Department, Faculty of Medicine, Ain Shams University, Cairo Governorate, Egypt., Haroun HK; Orthopedic Department, Faculty of Medicine, Ain Shams University, Cairo Governorate, Egypt.
Jazyk: angličtina
Zdroj: Archives of orthopaedic and trauma surgery [Arch Orthop Trauma Surg] 2024 Aug; Vol. 144 (8), pp. 3479-3489. Date of Electronic Publication: 2024 Jul 15.
DOI: 10.1007/s00402-024-05413-3
Abstrakt: Background: Fresh osteochondral allograft transplantation is a good treatment option of cartilage defects. However, this treatment option is not available in all countries due to limited graft availability and tissue banks limitations. The purpose of this study is to assess the short term functional and imaging outcomes of fresh osteochondral allograft transplantation in the knee using the femoral head of living donors.
Hypothesis: Fresh osteochondral allografts from the femoral heads of living donors is a valid graft source for management of distal Femur cartilage defects. This technique can improve functional knee scores with good radiological outcomes.
Study Design: Prospective case series.
Methods: Fifteen patients with full thickness cartilage defects of the distal femur underwent osteochondral allograft transplantation from the femoral heads of living donors. Grafts were transplanted by both shell and multiple dowels techniques. The average follow up duration was 18.3 months (range, 12-25 months). Patients were evaluated by Lysholm and International Knee Documentation Committee (IKDC) scores, radiography and MR imaging using Osteochondral Allograft MRI Scoring System (OCAMRISS).
Results: There was a statistically significant improvement (P < 0.001) in both Lysholm and IKDC average scores at 6 months and 12 months postoperative. Postoperative MRI was done at an average 6.8 months (range, 5-11 months) postoperative. The mean total OCAMRISS score was 3.4 (range, 1-7). A second look arthroscopy was done in four patients and showed intact articular cartilage in all three patients.
Conclusion: Femoral head of living donors is a valid new source for fresh osteochondral allograft transplantation of knee osteochondral lesions. Short term results showed improvement in clinical assessment scores. Follow up imaging showed graft incorporation and good MRI scores.
(© 2024. The Author(s).)
Databáze: MEDLINE
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