Outcomes After Fresh Osteochondral Allograft Transplantation for Medium to Large Chondral Defects of the Knee.

backgroundArticular cartilage defects of the knee can significantly impair function among young, high-demand patients. There are several techniques for chondral restoration, including osteochondral allograft transplantation (OCA), that may alleviate pain and re-create the native anatomy. However, clinical outcomes among athletic cohorts are limited. PURPOSE: To evaluate the efficacy and functional outcomes of OCA for medium to large osteochondral defects of the knee in physically active United States military servicemembers. STUDY

designCase series; Level of evidence, 4.

methodsA military health care database was queried to identify all OCA procedures performed between January 2009 and March 2013. Inclusion criteria were army personnel with a minimum of 2 years' follow-up. Exclusion criteria included incomplete follow-up, inaccurate coding, and nonmilitary status. Variables of interest included sex, age, lesion location, grade and size of the lesion, body mass index, tobacco use, preoperative and postoperative visual analog scale (VAS) scores for pain, and presence of perioperative complications. Overall failure was defined as the inability to return to preoperative functional activities because of persistent knee complaints (clinical failure) or a revision cartilage procedure or arthroplasty (surgical failure).

resultsA total of 61 patients (52 male; mean age, 31.7 years) were identified, with a mean 46.2-month follow-up. The mean VAS pain score improved from 4.10 ± 2.17 preoperatively to 2.68 ± 2.73 postoperatively (

conclusionOCA provided moderate success in retaining active-duty army servicemembers. Approximately two-thirds of patients undergoing OCA were able to return to their preinjury occupational activity, while approximately 57% of patients returned to prior levels without a subsequent revision chondral procedure or arthroplasty.