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Study shows OCA transplantation is effective for certain knee cartilage repairs

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Cartilage repair for femoral condyle lesions is a common procedure performed in the knee joint. New research investigated the effectiveness of a repair technique known as osteochondral allograft (OCA) transplantation.

Treatment options for isolated femoral condyle cartilage lesions have evolved but there is still uncertainty regarding longer-term clinical outcomes with current surgical techniques, according to the American Orthopaedic Society for Sports Medicine (AOSSM). The new study examined the outcome of OCA transplantation in 187 patients (200 knees). In all cases, dowel technique was used with commercially available surgical instruments utilising the minimum amount of bone necessary for fixation.

Results showed a significant improvement in clinical scores, high patient satisfaction, and low reoperation and clinical failure rates.

At a minimum follow-up of two and average of 6.7 years, International Knee Documentation Committee (IKDC) total scores improved from 43.7 to 76.2 on average, and Knee injury and Osteoarthritis Outcome Score (KOOS) for pain improved from 66.5 to 85.3, and 74.5 to 91.1 for activities of daily living. Further surgery was required in 52 knees (26%), of which 16 (8%) were considered failures, as defined by removal or revision of the allograft.

The findings were presented at the AOSSM’s recent Specialty Day in New Orleans.

“Our study demonstrated that the modern OCA transplantation technique, which utilises thin, dowel type grafts, was very effective in treating patients with femoral condyle cartilage lesions,” said lead author Dr Luís E. Tírico, who is currently with the University of Sao Paulo in Sao Paulo, Brazil and served as the research fellow and lead author on the presentation under Dr William Bugbee, director of Clinical Research and head of the Scripps Cartilage Restoration and Transplant Program at Scripps Clinic in La Jolla, California.

“In 200 cases, we noted an 89% satisfaction rate with those treated by this method, along with significant improvements in clinical scores and a low graft failure rate.”

The modern technique of OCA transplantation offers patients better results compared with other cartilage repair procedures, Dr Tírico added.

“These results appear to be equal or superior to any other cartilage repair procedure for the treatment of femoral condyle lesions and leads us to consider whether fresh OCA should be viewed as the current gold standard in cartilage repair for focal femoral condyle lesions.”