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Subsequent Surgeries Following Osteochondral Allograft and Osteochondral Autograft at up to Ten Years: An Analysis of over 2,000 Patients

Stephen M Gillinov, AB
UNITED STATES

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Subsequent Surgeries Following Osteochondral Allograft and Osteochondral Autograft at up to Ten Years: An Analysis of over 2,000 Patients

Patrick J Burroughs, MD, UNITED STATES Joseph B Kahan, MD, UNITED STATES Jay Moran, BS, UNITED STATES Stephen M Gillinov, AB, UNITED STATES Peter Y Joo, MD, MPH, UNITED STATES Christopher Schneble, MD, UNITED STATES Harold Gregory Moore, MD, UNITED STATES Jonathan Grauer, UNITED STATES Michael J. Medvecky, MD, UNITED STATES

Yale School of Medicine, New Haven, Connecticut, UNITED STATES

2023 Congress ePoster Presentation 2023 Congress Not yet rated

Sports Medicine

Orthopaedic Sports Medicine Outcome Studies

Diagnosis / Condition

Osteoarthritis

Treatment / Technique

Allograft

Summary: There were similarly high rates of subsequent surgery on five-year survival analysis between the osteochondral allograft and autograft cohorts.

Objectives:
Osteochondral allograft transplantation (OCA) and osteochondral autograft transfer (OAT) replace damaged cartilage with a plug of bone and overlying articular cartilage; however, there is limited research on the survival of these two differing osteoarticular grafting procedures.

We hypothesized that patients undergoing osteochondral allograft transplant would have a higher rate of subsequent surgeries over five years when compared to patients who underwent osteochondral autograft transfer.

Methods

The 2010-2018 PearlDiver Mariner administrative database was used to identify patients 10 to 59 years old who underwent osteochondral allograft (OCA) or osteochondral autograft transfer (OAT). All patients in the dataset meeting these criteria were assessed for subsequent knee surgeries, defined by the occurrence of a subsequent osteochondral (OCA or OAT) procedure or any type of knee arthroplasty for the duration of the time they were included in the dataset (maximum of ten years).

Analyses were performed for the total population and those with allograft versus autograft (compared with Fisher’s exact test). Five-year Kaplan-Meier survival curves for operation-free survival were compared using a Mantel-Cox Log-rank test. Statistical significance was set at p<0.05.

Results

In total, 1,631 patients were identified who underwent OCA (34.5 ± 12.1 years old, 51.6% females) and 967 patients were identified who underwent OAT (32.1 ± 12.9 years old, 51.0% females).

Both OCA and OAT had similarly high rates of subsequent knee surgeries, with no statistical differences between subsequent surgery rates of allograft and autograft patients. Kaplan-Meier survival curves comparing osteochondral allograft versus autograft transplant operation-free survival at five years were not significantly different (88.0% vs. 89.5%, p=0.235).

Conclusions

Osteochondral grafting procedures carry a relatively high rate of secondary surgery, which increases with time. Noting that there may be selection bias and differing indications between the osteochondral allograft and autograft cohorts, there were similarly high rates of subsequent surgery on five-year survival analysis.

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Subsequent Surgeries Following Osteochondral Allograft and Osteochondral Autograft at up to Ten Years: An Analysis of over 2,000 Patients

Subsequent Surgeries Following Osteochondral Allograft and Osteochondral Autograft at up to Ten Years: An Analysis of over 2,000 Patients

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Conclusions

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Subsequent Surgeries Following Osteochondral Allograft and Osteochondral Autograft at up to Ten Years: An Analysis of over 2,000 Patients

Subsequent Surgeries Following Osteochondral Allograft and Osteochondral Autograft at up to Ten Years: An Analysis of over 2,000 Patients

Methods

Results

Conclusions

More 2023 ISAKOS Congress Content