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. 2024 Jun;40(6):1938-1949.
doi: 10.1016/j.arthro.2023.11.026. Epub 2023 Dec 5.

Autologous Osteochondral Transfer of the Knee Demonstrates Continued High Rates of Return to Sport and Low Rates of Conversion to Arthroplasty at Long-Term Follow-Up: A Systematic Review

Jacob F Oeding  1 , Malik E Dancy  2 , Forrest W Fearington  3 , James A Pruneski  4 , Ayoosh Pareek  5 , Mario Hevesi  2 , Laszlo Hangody  6 , Christopher L Camp  2 , Aaron J Krych  2
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Autologous Osteochondral Transfer of the Knee Demonstrates Continued High Rates of Return to Sport and Low Rates of Conversion to Arthroplasty at Long-Term Follow-Up: A Systematic Review

Jacob F Oeding et al. Arthroscopy. 2024 Jun.

Abstract

Purpose: To perform a systematic review of the literature to evaluate (1) activity level and knee function, (2) reoperation and failure rates, and (3) risk factors for reoperation and failure of autologous osteochondral transfer (AOT) at long-term follow-up.

Methods: A comprehensive review of the long-term outcomes of AOT was performed. Studies reported on activity-based outcomes (Tegner Activity Scale) and clinical outcomes (Lysholm score and International Knee Documentation Committee score). Reoperation and failure rates as defined by the publishing authors were recorded for each study. Modified Coleman Methodology Scores were calculated to assess study methodological quality.

Results: Twelve studies with a total of 495 patients and an average age of 32.5 years at the time of surgery and a mean follow-up of 15.1 years (range, 10.4-18.0 years) were included. The mean defect size was 3.2 cm2 (range, 1.9-6.9 cm2). The mean duration of symptoms before surgery was 5.1 years. Return to sport rates ranged from 86% to 100%. Conversion to arthroplasty rates ranged from 0% to 16%. The average preoperative International Knee Documentation Committee scores ranged from 32.9 to 36.8, and the average postoperative International Knee Documentation Committee scores at final follow-up ranged from 66.3 to 77.3. The average preoperative Lysholm scores ranged from 44.5 to 56.0 and the average postoperative Lysholm scores ranged from 70.0 to 96.5. The average preoperative Tegner scores ranged from 2.5 to 3.0, and the average postoperative scores ranged from 4.1 to 7.0.

Conclusions: AOT of the knee resulted in high rates of return to sport with correspondingly low rates of conversion to arthroplasty at long-term follow-up. In addition, AOT demonstrated significant improvements in long-term patient-reported outcomes from baseline.

Level of evidence: Level IV, systematic review of Level I-IV studies.

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Conflict of interest statement

Disclosures The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: J.F.O. reports paid consultant for Kaliber.ai; M.H. reports paid consultant for DJO–Enovis, Moximed, and Vericel; publishing royalties, financial or material support from Elsevier; and editorial or governing board for Journal of Cartilage and Joint Preservation. C.L.C. reports paid consultant for Arthrex; research support from Major League Baseball; and publishing royalties, financial or material support from Springer. A.J.K. reports research support from Aesculap/B. Braun; editorial or governing board for American Journal of Sports Medicine; IP royalties, paid consultant for Arthrex; board or committee member for Arthroscopy Association of North America and International Cartilage Repair Society; and editorial or governing board for Springer. All other authors (M.E.D., F.W.F., J.A.P., A.P., L.H.) declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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