Initial Outcomes of Single versus Multiple-Plug Osteochondral Allograft Transplantation for Osteochondral Defects of the Knee: A Matched Cohort Analysis

Abstract

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 cm²) 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 (p < 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 (p > 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.

Keywords

knee - patella - knee, articular cartilage - knee, general

Authors' Contributions

J.S.R. performed data analysis and contributed to writing of the manuscript. F.R.C. and B.A. contributed to writing and editing of the manuscript. A.G.N. and P.H. collected the data and contributed to editing of the manuscript. A.H.G. and S.M.S. conceived the study and were involved in manuscript editing. All the authors read and approved the final version of the manuscript.

Ethical Committee Approval

Ethical approval was given by the Hospital for Special Surgery Institutional Review Board (IRB approved, #2020–2123).

Informed Consent

Informed consent of the patients was obtained prior to enrollment in the study.

Publikationsverlauf

Eingereicht: 09. April 2024

Angenommen: 16. Juli 2024

Accepted Manuscript online:
17. Juli 2024

Artikel online veröffentlicht:
01. August 2024

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