Purpose
The aim of this study is to evaluate a cohort of patients that received an osteochondral autograft transfer (OAT) and to correlate their clinical results with the patients’ age when the procedure was performed.
Methods
Retrospective comparative study. Inclusion criteria were patients that underwent an OAT to treat an osteochondral (OC) lesion and had a minimum 24-month follow-up. Eligible patients were categorized into two groups based on age at the time of surgery (<40 years and >=40 years). Postoperatively, each patient completed KOOS, IKDC, and Lyhsolm scales.
Results
51 patients were included (35 <40 years, 16 >=40 years). Mean follow-up: 4.2 years (2-7). There were no differences in OC lesion size and additional procedures (p=0.86 and p=0.56). Mean IKDC was 77.8 (34-100), mean Lysholm 83.1 (35-100), and mean KOOS 75.4 (38-94). For every year older IKDC decreased 0.7 (p=0.004). Lysholm and KOOS decreased 0.4 (p=0.03) and 0.5 (p=0.013) respectively. For patients <40 years, IKDC averaged 80.8 (SD 15.9) versus 71.2 (SD 19.4) in >=40 years (p=0.03). For patients <40 years, Lysholm averaged 85.9 (SD 10.8) versus 77.0 (SD 21.6) in >=40 years (p=0.02). For patients <40 years, KOOS averaged 78.3 (SD 11.8) versus 68.9 (SD 18.5) in >=40 years (p=0.01). There was a 100% sensibility to identify all patients with a poor IKDC from 34 years old (AUC 0.76). The same was observed for Lysholm (AUC 0.80).
Conclusions
OAT has good outcomes in patients younger than 40 years, and only fair outcomes in patients older than 40 years; with clinical scores that tend to decrease about half a point for each year older the patient is at the time of surgery. Based in the prognostic capacity of age, the ideal candidate for an OAT is a patient younger than 34 years old.