Results of ultra-fresh osteochondral allograft transplantation for large cartilage defects in the knee joint
Laszlo Rudolf Hangody1
, Tamas Gal2, Gabor Vasarhelyi1, Gyorgy Hangody1, Rehan Iftikhar Bukhari Syed3, Laszlo Hangody1
1Department of Orthopaedics & Trauma, Uzsoki Hospital, Budapest, Hungary
2Department of Traumatology, Semmelweis University, Budapest, Hungary
3Semmelweis University, Doctoral School of Clinical Medicine, Budapest, Hungary
Keywords: Allograft transplantation, cartilage repair, chondrocyte survival, massive osteochondral defect.
Abstract
Objectives: This study aims to investigate whether ultra-fresh osteochondral allograft (OCA) transplantation was a good therapeutic alternative for the treatment of otherwise challenging, massive osteochondral defects in the knee joint.
Patients and methods: Between April 2011 and July 2022, a total of 16 ultra-fresh knee transplantations (9 males, 7 females; median age: 30.2 years; range, 14 to 62 years) having large osteochondral defects on femoral condyles were included. The operations were performed by two surgeons. The condition of the patients were evaluated based on regular follow-up physical examinations, imaging studies and by recording and evaluating clinical scores (modified Cincinnati scores, and 2000 International Knee Documentation Committee [IKDC] scores).
Results: The median follow-up was 65±48 (range, 6 months to 12 years). At two years after transplantation, there was a significant improvement in the modified Cincinnati scores (preoperative score of 35.75 increased to 83.75; p<0.001) and also to the IKDC scores (preoperative score of 28.7 increased to 76.3; p<0.001). One patient developed an early septic complication, and another three patients underwent reoperation after the OCA transplantations for non-septic reasons.
Conclusion: Ultra-fresh OCA transplantation is a good therapeutic alternative for the treatment of otherwise challenging, massive osteochondral defects in the knee joint. Such a shortening of the transplantation time and its positive effect on the better long-term survival of transplanted chondrocytes has not yet been proven; however, the minimizing of transplantation time may create the conditions necessary for successful OCA transplantations many years after the implantation.
Citation: Hangody LR, Gal T, Vasarhelyi G, Hangody G, Bukhari Syed RI, Hangody L. Results of ultra-fresh osteochondral allograft transplantation for large cartilage defects in the knee joint. Jt Dis Relat Surg 2022;33(3):521-530.
The study protocol was approved by the Hungarian Medical Research Council (ETTTUKEB - 21st April 2011/2237-0/2011-EKU). The study was conducted in accordance with the principles of the Declaration of Helsinki.
A written informed consent was obtained from each patient.
Data Sharing Statement:
The data that support the findings of this study are available from the corresponding author upon reasonable request.
Idea/concept, design: L.R.H.; Control/supervision, critical review: L.H.; Data collection and/ or processing: G.H., G.V.; Analysis and/or interpretation: T.G., L.R.H.; Literature review: L.R.H., G.H.; Writing the article: L.H.; References and fundings: R.I.B.S.; Materials: G.V., T.G.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.