Fresh Osteochondral Allograft Transplantation for Fractures of the Knee
Autor: | Pamela A. Pulido, Julie C. McCauley, Luis Eduardo Passarelli Tirico, Guilherme Conforto Gracitelli, William D. Bugbee |
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Rok vydání: | 2017 |
Předmět: |
030222 orthopedics
medicine.medical_specialty Patellectomy Allograft transplantation business.industry Biomedical Engineering Physical Therapy Sports Therapy and Rehabilitation 030229 sport sciences Knee fracture Surgery Transplantation knee fracture functional outcomes 03 medical and health sciences 0302 clinical medicine Patient satisfaction osteochondral allograft transplant Clinical Research Survivorship curve Orthopedic surgery medicine Immunology and Allergy Patella business survivorship |
Zdroj: | Repositório Institucional da UNIFESP Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
ISSN: | 1947-6043 |
Popis: | Objective The purpose of this study was to evaluate functional outcomes and allograft survivorship among patients with knee fracture who underwent fresh osteochondral allograft (OCA) transplantation as a salvage treatment option. Design Retrospective analysis of prospectively collected data. Setting Department of Orthopaedic Surgery at one hospital. Patients Fresh OCAs were implanted for osteochondral lesions after knee fracture in 24 males and 15 females with an average age of 34 years. Twenty-nine lesions (74%) were tibial plateau fractures, 6 (15%) were femoral condyle fractures, and 4 (10%) were patella fractures. Main Outcome Measurements Clinical evaluation included modified Merle d’Aubigné-Postel (18-point), International Knee Documentation Committee, and Knee Society function scores, and patient satisfaction. Failure of OCA was defined as revision OCA or conversion to total knee arthroplasty (TKA). Results Nineteen of 39 knees (49%) had further surgery. Ten knees (26%) were considered OCA failures (3 OCA revisions, 6 TKA, and 1 patellectomy). Survivorship of the OCA was 82.6% at 5 years and 69.6% at 10 years. Among the 29 knees (74%) that had the OCA still in situ, median follow-up was 6.6 years. Pain and function improved from preoperative to latest follow-up; 83% of patients reported satisfaction with OCA results. Conclusion OCA transplantation is a useful salvage treatment option for osteochondral lesions caused by knee fracture. Although the reoperation rate was high, successful outcome was associated with significant clinical improvement. |
Databáze: | OpenAIRE |
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