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Review
. 2025 Feb 4:S0749-8063(25)00058-1.
doi: 10.1016/j.arthro.2025.01.040. Online ahead of print.

Osteochondral Allograft Transplantation With Concomitant Meniscal Allograft Transplantation Improves Clinical Outcomes and Yields High Patient Satisfaction: A Systematic Review

Melissa L Carpenter  1 , Eric J Cotter  1 , Juan Bernardo Villarreal-Espinosa  1 , Samuel Alfonsi  1 , Fernando Gómez-Verdejo  1 , Cameron Gerhold  1 , Udit Dave  1 , Adam B Yanke  1 , Brian J Cole  1 , Jorge Chahla  2
Affiliations
Review

Osteochondral Allograft Transplantation With Concomitant Meniscal Allograft Transplantation Improves Clinical Outcomes and Yields High Patient Satisfaction: A Systematic Review

Melissa L Carpenter et al. Arthroscopy. .

Abstract

Purpose: To conduct a systematic review evaluating subjective patient-reported outcomes, reoperations, and graft failure after concomitant osteochondral allograft (OCA) transplantation and meniscal allograft transplantation (MAT).

Methods: A literature search was performed by querying the MEDLINE, Embase, and PubMed databases according to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. The inclusion criteria were limited to peer-reviewed, English-language, Level I to IV studies with at least 10 patients that reported clinical outcomes and complications after OCA transplantation with concomitant MAT for osteochondral defects and meniscal deficiency with minimum 2-year follow-up. For most of the included studies, failure was defined as conversion to arthroplasty, revision OCA, or graft failure on postoperative imaging.

Results: Six studies with a total of 188 patients met the inclusion and exclusion criteria. The mean patient age was 32.4 years (range, 15-66 years). Improvement in the following outcome scores was observed across all included studies from preoperatively to postoperatively: Lysholm knee score (+21 to +26.69); International Knee Documentation Committee Subjective Knee Form score (+19 to +26.55); Knee Injury and Osteoarthritis Outcome Score (KOOS) Pain subscale (+17.91 to +26), KOOS Symptom subscale (+9 to +18.16), KOOS Activities of Daily Living subscale (+11.91 to +23.4), KOOS Sport subscale (+19 to +26.04), KOOS Quality of Life subscale (+22 to +35.01), 12-Item Short Form Survey physical score (+5 to +12.26), and 12-Item Short Form Survey mental score (+1.8 to +4) (P < .05 for all). The reoperation rate was between 6.7% and 54%. The failure rate was between 13% and 22.9%. Although patient satisfaction data were only available in 2 studies, 82% to 90% of patients would choose to undergo OCA transplantation with MAT again.

Conclusions: OCA transplantation with concomitant MAT for the treatment of focal chondral defects in the presence of meniscal deficiency results in improved patient-reported outcome measures with high patient satisfaction rates. The mean reoperation rate and failure rate at a mean follow-up time of 4.7 years are 37.3% and 17.1%, respectively, which are expected and consistent with the existing literature on isolated procedures.

Level of evidence: Level IV, systematic review of Level III and 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: A.B.Y. reports a consulting or advisory relationship with Allosource, JRF Ortho, and Stryker; owns equity or stocks in Patient IQ, Sparta Biomedical, and Icarus; and receives nonfinancial support from Patient IQ and Sparta Biomedical. B.J.C. receives nonfinancial support from B Braun Aesculap Japan, Arthrex, and National Institutes of Health (National Institute of Arthritis and Musculoskeletal and Skin Diseases and National Institute of Child Health and Human Development); reports board membership with American Journal of Sports Medicine and Journal of the American Academy of Orthopedic Surgeons; reports a consulting or advisory relationship with Arthrex; receives funding grants from Arthrex, Elsevier Publishing, JRF Ortho, Medwest Associates, Vericel, Bioventus, Acument, DJO, Anika Therapeutics, Endo Pharmaceuticals, Flexion Therapeutics, and Pacira Pharmaceuticals; owns equity or stocks in Bandgrip and Ossio; provides paid expert testimony for Ossio and Endo Pharmaceuticals; receives travel reimbursement from GE Healthcare; and receives speaking and lecture fees from Terumo BCT. J.C. is a board or committee member of American Orthopaedic Society for Sports Medicine, Arthroscopy Association of North America, and International Society of Arthroscopy, Knee Surgery, and Orthopaedic Sports Medicine; is a paid consultant for Arthrex, ConMed Linvatec, Ossur, and Smith & Nephew; and is a paid presenter or speaker for Smith & Nephew. All other authors (M.L.C., E.J.C., J.B.V-E., S.A., F.G-V., C.G., U.D.) 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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