scholarly journals Arthroscopic Osteochondral Autograft Transfer System Procedure of the Lateral Femoral Condyle with Donor-Site Backfill Using Osteochondral Allograft Plug

Author(s):  
Alvarho J. Guzman ◽  
Therese Dela Rueda ◽  
Shane M. Rayos Del Sol ◽  
Stewart A. Bryant ◽  
Sarah Jenkins ◽  
...  
2003 ◽  
Vol 24 (3) ◽  
pp. 283-287 ◽  
Author(s):  
Allen F. Anderson ◽  
James R. Ramsey

Chondroblastoma is a benign cartilaginous lesion of bone. When occurring in a position juxtaposed to articular cartilage, treatment is directed at removal of the tumor with preservation of the articular cartilage. In this case, a chondroblastoma of the talus with erosion into the articular cartilage was treated with transfer of an osteochondral autograft from the ipsilateral femoral condyle. At two-year follow-up, the patient was symptom free and magnetic resonance imaging revealed complete incorporation of the graft. This case is presented as a representative example of osteochondral autograft transfer surgery (OATS) for the treatment of chondroblastoma.


Author(s):  
Steven F. DeFroda ◽  
Steven L. Bokshan ◽  
Daniel S. Yang ◽  
Alan H. Daniels ◽  
Brett D. Owens

AbstractManagement of cartilage lesions of the knee can be complex, time consuming, and controversial, especially without a widely agreed upon “gold-standard” management. The PearlDiver database (www.pearldiverinc.com, Fort Wayne, IN) was queried for surgical management of cartilage lesions specified by Current Procedure Terminology (CPT) codes: 29877, chondroplasty; 29879, microfracture/drilling; 29866, arthroscopic osteochondral autograft; 29867, arthroscopic osteochondral allograft; 27412, autologous chondrocyte implantation (ACI); 27415, open osteochondral allograft; or 27416, open osteochondral autograft. Procedures were categorized as palliative (chondroplasty), microfracture/drilling, or restorative (arthroscopic osteochondral autograft; arthroscopic osteochondral allograft; ACI; open osteochondral allograft; or open osteochondral autograft). Linear regression was performed to determine the significance of yearly trend across each procedure.From 2007 to 2016, a total of 35,506 surgical procedures were performed. The average yearly incidence was 7.8 per 10,000 patients. Overall, palliative techniques (chondroplasty) were more common (1.8:1 ratio for chondroplasty to microfracture and 34:1 ratio chondroplasty to restoration procedure). There was a trend of decreasing incidence of palliative procedures seen by a significant decrease in the ratio of palliative to microfracture/restorative procedures of 0.2512 each year from 2007 to 2016 (p < 0.001). This decrease followed a linear trend (R 2 = 0.9123). In 2013, the number and incidence of the palliative procedures declined below that of microfracture procedures, with microfracture being most common from 2013 to 2016. Palliative chondroplasty was no longer the most commonly performed procedure for cartilage lesions in the United States from 2007 to 2016, as more surgeons opted for microfracture procedures instead. Restorative procedures (ACI, osteochondral autograft transfer system) remained unchanged over the study period, in accordance with the sports medicine literature; however, early functional outcomes studies do show the equivalency and in some cases superiority compared with microfracture. This is Level III study.


2018 ◽  
Vol 46 (3) ◽  
pp. 573-580 ◽  
Author(s):  
Rachel M. Frank ◽  
Simon Lee ◽  
Eric J. Cotter ◽  
Charles P. Hannon ◽  
Timothy Leroux ◽  
...  

Background: Osteochondral allograft transplantation (OCA) is often performed with concomitant meniscus allograft transplantation (MAT) as a strategy for knee joint preservation, although to date, the effect of concomitant MAT on outcomes and failure rates after OCA has not been assessed. Purpose: To determine clinical outcomes for patients undergoing OCA with MAT as compared with a matched cohort of patients undergoing isolated OCA. Study Design: Control study; Level of evidence, 3. Methods: Patients who underwent OCA of the medial or lateral femoral condyle without concomitant MAT by a single surgeon were compared with a matched group of patients who underwent OCA with concomitant MAT (ipsilateral compartment). The patients were matched per age, sex, body mass index, and number of previous ipsilateral knee operations ±1. Patient-reported outcomes, complications, reoperations, and survival rates were compared between groups. Results: One hundred patients undergoing OCA (50 isolated, 50 with MAT) with a mean ± SD follow-up of 4.9 ± 2.7 years (minimum, 2 years) were included (age, 31.7 ± 9.8 years; 52% male). Significantly more patients underwent OCA to the medial femoral condyle (n = 59) than the lateral femoral condyle (n = 41, P < .0001). Patients underwent 2.7 ± 1.7 operations on the ipsilateral knee before OCA. There were no significant differences between the groups regarding reoperation rate (n = 18 for OCA with MAT, n = 17 for OCA without MAT, P = .834), time to reoperation (2.2 ± 2.4 years for OCA with MAT, 3.4 ± 2.7 years for OCA without MAT, P = .149), or failure rates (n = 7 [14%] for OCA with MAT, n = 7 [14%] for OCA without MAT, P > .999). There were no significant differences in patient-reported clinical outcome scores between the groups at final follow-up. There was no significant difference in failure rates between patients undergoing medial femoral condyle OCA (n = 12, 15.3%) and lateral femoral condyle OCA (n = 5, 12.2%, P = .665). Conclusion: These results imply that with appropriate surgical indications to address meniscus deficiency in patients otherwise indicated for OCA and despite the added surgical time and complexity of concomitant MAT, outcomes are favorable, with an 86% OCA graft survivorship at 5 years. This information can be used to counsel patients undergoing OCA with concomitant MAT as part of a knee joint preservation strategy.


2018 ◽  
Vol 26 (3) ◽  
pp. 183-188 ◽  
Author(s):  
Austin V. Stone ◽  
David R. Christian ◽  
Michael L. Redondo ◽  
Adam B. Yanke ◽  
Taylor M Southworth ◽  
...  

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