Summary
The mean ACTOCA score evaluating CT at 6 months showed a statistically significant correlation with the clinical results at 30 months
Abstract
Introduction
Information regarding the ability of imaging studies to predict clinical outcomes after fresh osteochondral allograft (FOCA) transplantation of the knee is lacking.
Aim
We aimed to determine the value of CT scans to predict the clinical outcome of FOCA transplantation using the Assessment Computed Tomography Osteochondral Allograft (ACTOCA) score.
Method
We prospectively collected data of all consecutive patients (n = 38) who underwent FOCA transplantation for osteochondral knee lesions and had a minimum follow-up of 2 years.
CT scans performed 6 months post-surgery were evaluated by a musculoskeletal radiologist using the ACTOCA scoring system. The radiologist was blinded to the patients’ medical history.
Clinical outcomes were assessed preoperatively and at 12 and 30 months postoperatively using the IKDC score, the Kujala score, the Tegner activity scale, and WOMET score.
Descriptive statistics were used to determine patient and lesion characteristics. The results are given as number of cases and/or percentage for categorical data, and as mean, standard deviation and range, for quantitative variables. Variables repeated during the trial (functional scales) were analysed by ANOVA tests for repeated measures with Greenhouse-Geisser correction to avoid sphericity. Correlation between clinical results and imaging results was analysed using Pearson correlation coefficient. The overall level of significance was set at 0.05 for two-sided tests.
Results
The ACTOCA score at 6 months after surgery showed a statistically significant correlation with clinical results at 12 and 30 months.
The correlation was better at 30 months, showing a high negative correlation with the IKDC score (-0.663) and a moderate negative correlation with Kujala, WOMET and Tegner scores (-0.5127; -0.547 and -0.593 respectively) (p<0.001).
Conclusions
The mean ACTOCA score evaluating CT at 6 months showed a statistically significant correlation with the clinical results in IKDC, Kujala, WOMET and Tegner scores at 30 months, confirming the predictive value of the ACTOCA for use in clinical practice.