Large osteochondral lesions of the femoral condyles: treatment with fresh frozen and irradiated allograft using the Mega OATS technique

Hohmann, Erik and Tetsworth, Kevin (2016) Large osteochondral lesions of the femoral condyles: treatment with fresh frozen and irradiated allograft using the Mega OATS technique. The Knee, 23 3: 436-441. doi:10.1016/j.knee.2016.01.020


Author Hohmann, Erik
Tetsworth, Kevin
Title Large osteochondral lesions of the femoral condyles: treatment with fresh frozen and irradiated allograft using the Mega OATS technique
Journal name The Knee   Check publisher's open access policy
ISSN 1873-5800
0968-0160
Publication date 2016
Year available 2016
Sub-type Article (original research)
DOI 10.1016/j.knee.2016.01.020
Open Access Status Not Open Access
Volume 23
Issue 3
Start page 436
End page 441
Total pages 6
Place of publication Amsterdam, Netherlands
Publisher Elsevier
Collection year 2017
Language eng
Formatted abstract
Background

The purpose of this study was to review the clinical results of irradiated fresh frozen osteochondral allografts for large osteochondral defects of the knee using the Mega-OATS technique.

Methods

Nine patients with a mean age of 32.1 ± 6.6 (18 to 44) underwent Mega-OATS transplantation with irradiated (2.5 Mrad), fresh frozen distal femur allograft. Three patients also underwent ACL-reconstruction; one patient a high tibial osteotomy. The underlying indication was osteochondrosis dissecans in four and trauma in five patients. The defect size was 25 × 25 mm in three patients and 30 × 30 in six patients and the depth ranged from eight to 14 mm. All OCD lesions were located on the medial femoral condyle; two of the traumatic lesions were located on the lateral femoral condyle. Clinical outcome was assessed using the Lysholm and IKDC scores. Radiographic incorporation was evaluated using serial radiographs and MR imaging at one year post surgery. All patients were reviewed at three, six, 12, and 24 months following surgery.

Results

The Lysholm (IKDC) score improved significantly (p = 0.02 resp. p = 0.007) within and between patients during the follow-up period from 40.9 (37) to 90.9 (87.1) at 2 years. Radiographic union was observed in all patients at three months; on MR imaging at one year osseous integration was observed in eight patients. Graft subsidence with loss of the overlying cartilage was observed in one and subchondral cystic changes at the implantation side were seen in another patient.

Conclusion

The results of this case series suggest that irradiated osteochondral allograft provides significant medium-term clinical improvement in patients treated for large osteochondral lesions of the femoral condyles.
Keyword Osteochondral allograft transplantation
Mega-OATS
Irradiated allograft
Osteochondral defect
Cartilage
Femoral condyles
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
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