Johnson CC, et al. - This study focused on the short-term clinical and radiographic outcomes of using decellularized osteochondral (OC) allograft plugs in the treatment of distal femoral OC lesions. As short-term failure rate was high, caution ought to be exercised when using a decellularized OC allograft plugs implant for treating OC lesions of the knee, as similar outcomes had not been noted with other cartilage restoration techniques.

Methods

• Researchers identified patients treated with the decellularized OC allograft plugs implant using an Institutional Review Board-approved database with prospectively collected data.
• They assessed demographic information, patient-reported outcomes, magnetic resonance imaging (MRI), and the number and type of reoperations.
• Failure was defined as revision surgery with removal of the implant.
• Using the Short Form-36, Activity of Daily Living Score, International Knee Documentation Committee Subjective Evaluation, Cincinnati Knee Rating System, and Marx Activity Scale, they examined patients both pre- and postoperatively.
• They also assessed MRIs using the OsteoChondral Allograft MRI Scoring System.

Results

• 34 patients were identified, with a mean age of 45 (±11.9) years; 71% were male.
• Data reported prior ipsilateral surgical intervention in fifteen (44%) patients.
• It was noted that the mean defect size was 4 (±1.5) cm², median number of allografts per knee was 2 (range, 1-5) and mean follow-up duration was 15.5 months (range, 6-24).
• Findings reported that 10 patients (29%) required revision surgery with removal of the implant.
• At 2 years, implant survivorship was 61%.
• Researchers determined that female gender was independently predictive of failure, with a hazard ratio of 9.4 (95% confidence interval [CI], 2.0-58.9;P = .005).
• In addition, they found that defect size was also independently predictive of failure, with a hazard ratio of 1.9 per 1 cm² increase (95% CI, 1.2-3.1; P = .005).
• Significantly improved osseous integration (P = .0086) and opposing cartilage (P = .019) were demonstrated in the 1 year postoperative MRIs in the nonfailure group as compared with the failure group.