scholarly journals MO936KIDNEY RE-TRANSPLANTATION: NOT TOO OLD FOR A SECOND CHANCE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Clara Pardinhas ◽  
Rita Leal ◽  
Francisco Caramelo ◽  
Teofilo Yan ◽  
Carolina Figueiredo ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Clinical Outcomes ◽  
Kidney Transplant ◽  
Graft Survival ◽  
Older Patients ◽  
Logrank Test ◽  
Versus Group ◽  
Group 2 ◽  
Group 1

Abstract Background and Aims A growing number of end-stage renal disease patients waiting for a kidney transplant (KT) are older than 50 years old. Consequently, many kidney transplant recipients will be in need of dialysis or re-transplantation at an older age. For young patients, re-transplantation offers an advantage over dialysis but in the elderly these benefits are not well established. For selected older recipients, with rigorous cardiovascular and neoplastic evaluation, immunosenescence might actually provide an advantage in graft outcomes. Our aim was to compare major clinical outcomes between patients older and younger than 60 years old at re-transplantation, and between first and second KT for recipients older than 60 years old. Method We performed a retrospective, longitudinal study, that included all patients submitted to a second KT between January 2008 and December 2019, excluding patients with more than 2 grafts or multi-organ transplant. We defined two groups according to recipient’s age at re-transplant, older and younger than 60 years-old, and compared major clinical outcomes such as biopsy proven acute rejection, death-censored graft survival and patients’ survival. Afterwards, we selected KT patients older than 60 years, and compared the same outcomes for patients with first and second KT. Follow-up time was defined at 1st June 2020 for functioning grafts or at graft failure (including death with a functioning graft). Results We included 109 patients with a second KT, 13 (12%) older than 60-years-old (group 1), with a mean age of 62.85 ± 2.9 years, and 96 (88%) younger than 60-years-old (group 2), with a mean age of 40.4 ± 10.6 years. Group 1 recipients were all male (100% vs 59.4%; p=0.004) and had higher body mass index (25±2.8 vs 22.5±3.6 kg/m2, p=0.016). Recipients from the group 1, waited less time for their second KT (37.7±21.8 vs 64.8±58.8 months; p=0.003), but had older donors (59.5±13.5 vs 45.9±11.5 years old; p<0.001), and significantly more expanded-criteria donors (76.9% vs 26%; p<0.001). HLA mismatch and PRA (%) were similar for both groups. Regarding biopsy proven acute rejection, there were no events for older patients compared to 21 patients (22%) for the younger group (p<0.05). Death censored graft survival was similar for both groups (logrank test p=0.124) with similar 1 year and 5 years graft survival (group 1: 91.7%, 82.5% versus group 2: 90.1%, 85.2% p=0.944). We found no difference in patients’ mortality at follow up between both groups (logrank test p=0.0124). Focusing on differences between re-transplantation (group 1, N=13) and first kidney transplant (group 2, N=390) in patients older than 60-year-old, there were more males in group one, but we found no other differences in recipient and donor demographic characteristics, or waiting time for kidney graft (38±22 versus 47±25 months, p=0.17). As expected, PRA was significantly higher in group 1 (25 ±29% vs 3.7±11%, p=0.018) but there were no differences in HLA matching. At follow-up, the mean time post-transplant for group 1 was 47±39.68 and for group 2 was 63 ±39.9 months (p=0.144). There were no differences regarding acute rejection episodes (0% vs 3.1%; p=0.521) or death censored graft survival was similar at 1 and 5 years (group 1: 91.7%, 82.5% versus group 2: 93.4%, 86.3% p=0.983). Conclusion In carefully selected patients, advanced age should not be a contraindication to kidney re-transplantation. Immunosenescense might lead to lower acute rejection rates and older donors might be used with less restrictions. In our study, major clinical outcomes were comparable to their younger counterparts with a second graft and to older patients with a first graft.

Etiology of Cartilage Lesions Does Not Affect Clinical Outcomes of Patellofemoral Autologous Chondrocyte Implantation

Cartilage ◽  
2021 ◽  
pp. 194760352110309
Author(s):  
Alexandre Barbieri Mestriner ◽  
Jakob Ackermann ◽  
Gergo Merkely ◽  
Pedro Henrique Schmidt Alves Ferreira Galvão ◽  
Luiz Felipe Morlin Ambra ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Autologous Chondrocyte Implantation ◽  
Second Generation ◽  
Cartilage Lesion ◽  
Chondrocyte Implantation ◽  
Group 3 ◽  
Group 2 ◽  
Autologous Chondrocyte ◽  
Group 1

Objective To determine the relationship between cartilage lesion etiology and clinical outcomes after second-generation autologous chondrocyte implantation (ACI) in the patellofemoral joint (PFJ) with a minimum of 2 years’ follow-up. Methods A retrospective review of all patients that underwent ACI in the PFJ by a single surgeon was performed. Seventy-two patients with a mean follow-up of 4.2 ± 2.0 years were enrolled in this study and were stratified into 3 groups based on the etiology of PFJ cartilage lesions: patellar dislocation (group 1; n = 23); nontraumatic lesions, including chondromalacia, osteochondritis dissecans, and degenerative defects (group 2; n = 28); and other posttraumatic lesions besides patellar dislocations (group 3; n = 21). Patient’s mean age was 29.6 ± 8.7 years. Patients in group 1 were significantly younger (25.4 ± 7.9 years) than group 2 (31.7 ± 9.6 years; P = 0.025) and group 3 (31.5 ± 6.6 years; P = 0.05). Body mass index averaged 26.2 ± 4.3 kg/m2, with a significant difference between group 1 (24.4 ± 3.2 kg/m2) and group 3 (28.7 ± 4.5 kg/m2; P = 0.005). A clinical comparison was established between groups based on patient-reported outcome measures (PROMs) and failure rates. Results Neither pre- nor postoperative PROMs differed between groups ( P > 0.05). No difference was seen in survivorship between groups (95.7% vs. 82.2% vs. 90.5%, P > 0.05). Conclusion Cartilage lesion etiology did not influence clinical outcome in this retrospective study after second generation ACI in the PFJ. Level of Evidence Level III, retrospective comparative study.

MO941CLINICAL OUTCOMES IN KIDNEY RE-TRANSPLANTATION

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Clara Pardinhas ◽  
Rita Leal ◽  
Francisco Caramelo ◽  
Teofilo Yan ◽  
Carolina Figueiredo ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Kidney Transplant ◽  
Graft Survival ◽  
Graft Failure ◽  
Graft Function ◽  
Delayed Graft Function ◽  
First Year ◽  
Kidney Transplant Recipients ◽  
Post Transplant

Abstract Background and Aims As kidney transplants are growing in absolute numbers, so are patients with failed allografts and thus potential candidates for re-transplantation. Re-transplantation is challenging due to immunological barriers, surgical difficulties and clinical complexities but it has been proven that successful second transplantation improves life expectancy over dialysis. It is important to evaluate re-transplantation outcomes since 20% of patients on the waiting list are waiting for a second graft. Our aim was to compare major clinical outcomes such as acute rejection, graft and patient survival, between patients receiving a first or a second kidney transplant. Method We performed a retrospective study, that included 1552 patients submitted to a first (N=1443, 93%) or a second kidney transplant (N=109, 7%), between January 2008 and December 2018. Patients with more than 2 grafts or multi-organ transplant were excluded. Demographic, clinical and histocompatibility characteristics of both groups were registered from our unit database and compared. Delayed graft function was defined has the need of dialysis in the first week post-transplant. All acute rejection episodes were biopsy proven, according to Banff 2017 criteria. Follow-up time was defined at 1st June 2020 for functioning grafts or at graft failure (including death with a functioning graft). Results Recipients of a second graft were significantly younger (43 ±12 vs 50 ± 13 years old, p<0.001) and there were significantly fewer expanded-criteria donors in the second transplant group (31.5% vs 57.5%, p<0.001). The waiting time for a second graft was longer (63±50 vs 48±29 months, p=0.011). HLA mismatch was similar for both groups but PRA was significantly higher for second KT patients (21.6±25% versus 3±9%; p<0.001). All patients submitted to a second KT had thymoglobulin as induction therapy compared to 16% of the first KT group (p<0.001). We found no difference in primary dysfunction or delayed graft function between groups. Acute rejection was significantly more frequent in second kidney transplant recipients (19% vs 5%, p<0.001), being 10 acute cellular rejections, 7 were antibody mediated and 3 were borderline changes. For the majority of the patients (85%), acute rejection occurred in the first-year post-transplant. Death censored graft failure occurred in 236 (16.4%) patients with first kidney transplant and 25 (23%) patients with a second graft, p=0.08. Survival analysis showed similar graft survival for both groups (log-rank p=0.392). We found no difference in patients’ mortality at follow up for both groups. Conclusion Although second graft patients presented more episodes of biopsy proven acute rejection, especially at the first-year post-transplant, we found no differences in death censored graft survival or patients’ mortality for patients with a second kidney transplant. Second transplants should be offered to patients whenever feasible.

scholarly journals Impact of antiretroviral therapy on clinical outcomes in HIV+ kidney transplant recipients: Review of 58 cases

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 2893 ◽  
Author(s):  
Rossana Rosa ◽  
Jose F. Suarez ◽  
Marco A. Lorio ◽  
Michele I. Morris ◽  
Lilian M. Abbo ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Acute Rejection ◽  
Clinical Outcomes ◽  
Kidney Transplant ◽  
Graft Survival ◽  
Patient Survival ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Serious Infections ◽  
The Impact

Background: Antiretroviral therapy (ART) poses challenging drug-drug interactions with immunosuppressant agents in transplant recipients.  We aimed to determine the impact of specific antiretroviral regimens in clinical outcomes of HIV+ kidney transplant recipients. Methods: A single-center, retrospective cohort study was conducted at a large academic center. Subjects included 58 HIV- to HIV+ adult, first-time kidney transplant patients. The main intervention was ART regimen used after transplantation.  The main outcomes assessed at one- and three-years were: patient survival, death-censored graft survival, and biopsy-proven acute rejection; we also assessed serious infections within the first six months post-transplant. Results: Patient and graft survival at three years were both 90% for the entire cohort. Patients receiving protease inhibitor (PI)-containing regimens had lower patient survival at one and three years than patients receiving PI-sparing regimens: 85% vs. 100% (p=0.06) and 82% vs. 100% (p=0.03), respectively. Patients who received PI-containing regimens had twelve times higher odds of death at 3 years compared to patients who were not exposed to PIs (odds ratio, 12.05; 95% confidence interval, 1.31-1602; p=0.02).  Three-year death-censored graft survival was lower in patients receiving PI vs. patients on PI-sparing regimens (82 vs 100%, p=0.03). Patients receiving integrase strand transfer inhibitors-containing regimens had higher 3-year graft survival. There were no differences in the incidence of acute rejection by ART regimen. Individuals receiving PIs had a higher incidence of serious infections compared to those on PI-sparing regimens (39 vs. 8%, p=0.01). Conclusions: PI-containing ART regimens are associated with adverse outcomes in HIV+ kidney transplant recipients.

scholarly journals Effect of donor and host factors on corneal graft transparency

2021 ◽  
Vol 6 (4) ◽  
pp. 56-61
Author(s):  
Dr. Amisha Jain ◽  
◽  
Dr. Hema Joshi ◽  
Dr. Nimish Jain ◽  
◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Cell Count ◽  
Graft Survival ◽  
Graft Failure ◽  
Failure Group ◽  
Endothelial Cell Count ◽  
Donor Factors ◽  
Group 2 ◽  
Group 1

Objective: To study the correlation between donor factors and recipients' factors on graft clarity.Materials and methods: The study comprised 30 cases of Keratoplasty surgery with a follow up of6 months. All donor corneas were evaluated by Konan specular microscope for endothelial cellcount; details of the donor like age, cause of death were noted. The patients were divided into twogroups, Group 1 had graft failure, and Group 2 had clear corneas. Observation and Result: Therewere 12 patients in group 1 and 18 patients in group 2 with six months of follow up. The meanendothelial cell count in group 1 was 1942.3/mm2, and group 2 was 2334.8/mm2. There is asignificant difference in the mean endothelial cell count between the two groups. On analysing theindication for Keratoplasty in two groups, the outcome was best for the corneal opacity group duringworst for the graft failure group. Conclusion: Donor endothelial cell count significantly influencedgraft outcome; rest donor factors (age, death enucleation interval, enucleation surgery interval)don't affect graft survival. Indication for Keratoplasty is a significant predictor of graft survival.

Isokinetic Strength Comparison of Tuberosity Fractures of the Proximal Fifth Metatarsal Treated With Elastic Bandage vs Cast

2020 ◽  
Vol 41 (6) ◽  
pp. 674-682
Author(s):  
Serkan Bayram ◽  
Alper Şükrü Kendirci ◽  
Doğan Kıral ◽  
Türker Şahinkaya ◽  
Mehmet Ekinci ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Clinical Outcomes ◽  
Assistive Devices ◽  
Cast Immobilization ◽  
Functional Scores ◽  
Ankle Muscle ◽  
Group 2 ◽  
Elastic Bandage ◽  
Group 1

Background: The aim of this study was to compare the strength of injured and healthy ankle muscle as well as functional and clinical outcomes between patients with proximal fifth metatarsal tuberosity fractures who received elastic bandage treatment and those who received cast immobilization. Methods: Sixty-five patients who presented to our clinic between February 2018 and April 2019 were randomly divided into 2 groups: 33 received elastic bandages (group 1) and 32 received cast immobilization (group 2). All patients were scheduled for follow-up appointments at our clinic after 2, 4, 8, 12, and 24 weeks. Visual analog scale–foot and ankle (VAS-FA) score, time missed from work, and using assistive devices were recorded as clinical outcomes. Both ankle plantarflexion-dorsiflexion and inversion-eversion muscle strengths (peak torque) were measured using an isokinetic dynamometer for each group and were compared with those of the healthy extremities. Results: The mean missed work was 11.3 days in group 1 and 27.6 days in group 2. Groups 1 and 2 used assistive devices for a mean of 6.7 and 16.2 days, respectively ( P = .001). Group 1 had a significantly higher VAS-FA score at the 2nd, 4th, and 8th week of follow-up compared with group 2, and no significant differences were observed at the time of injury and at the 12th and 24th weeks. The muscle strength deficits in group 1 were present at the 4th week, whereas those in the cast immobilization group were determined at the 4th and 8th weeks in all muscles. During the 12th and 24th week of follow-up, no significantly differences in both extremities were observed between the groups. Conclusion: Elastic bandage treatment was better than cast immobilization in terms of preserving ankle muscle strength, clinical outcomes, and functional scores regardless of the degree of fracture displacement. Moreover, the present study emphasized that cast immobilization offered no advantages in this fracture treatment. Level of Evidence: Level I, prognostic randomized controlled trial.

scholarly journals Curative effect and Safety in Anteromedial Osteoarthritis Patients over 80 Years Old Undergoing Oxford Unicompartmental Knee Arthroplasty (UKA) in China: A Single-Center Retrospective Study

2019 ◽  
Author(s):  
Jingbo Cheng ◽  
Mingli Feng ◽  
Guanglei Cao ◽  
Zheng Li ◽  
Shuai An ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Older Patients ◽  
Perioperative Complications ◽  
Womac Score ◽  
Younger Patients ◽  
Group 2 ◽  
Hss Score ◽  
Oxford Unicompartmental Knee Arthroplasty ◽  
Group 1

Abstract Background: Oxford Unicompartmental Knee Arthroplasty (UKA) has increased rapidly around the world, and the effectiveness and safety of a minimally invasive surgical approach for it demonstrate excellent outcome. Oxford UKA represents an interesting solution for older patients. The aim of our study is to evaluate the perioperative complications and short-term clinical outcome and analyze the safety for older patients who undergo Oxford UKA.Methods: A retrospective review was performed of all patients who underwent Oxford UKA between June 2015 and January 2018. We divided all patients into two groups (ages 60–80; age over 80). We used the HSS score and WOMAC score to evaluate the general condition of the patients’ knees. We also recorded perioperative complications and long-term complications. Result:130 patients (139 knees) between the ages of 60 and 80 (Group 1) and 65 patients (70 knees) over 80 years old (Group 2) were included in the study. The mean follow-up was 22.04 ± 11.04 and 21.76 ± 10.20 months in Group 1 and 2, respectively. At last follow-up, the patients in Group 2 showed lower function scores, but both the HSS score and the WOMAC score were significantly improved in both groups after surgery. The rate of perioperative complications and other complications in elderly patients is the same as in younger patients. Conclusion: Oxford UKA showed validity and safety for elderly patients in China. The knee joint pain symptoms of the elderly patients are relieved and the function is well restored, but the function is still poor compared with the younger patients.

scholarly journals Delayed Graft Function and Acute Rejection in Kidney Transplant Patients with Positive Panel-Reactive Antibody and Negative Donor-Specific Antibodies

2020 ◽  
Vol 12 (4) ◽  
Author(s):  
Ha Nguyen Thi Thu ◽  
Manh Bui Van ◽  
Dung Nguyen Thi Thuy ◽  
Kien Truong Quy ◽  
Duc Nguyen Van ◽  
...  
Keyword(s):  
Acute Rejection ◽  
Kidney Transplant ◽  
Kidney Function ◽  
Graft Function ◽  
Post Transplantation ◽  
Transplant Patients ◽  
Kidney Transplant Patients ◽  
Group 2 ◽  
Reactive Antibody ◽  
Group 1

Background: Delayed graft function (DGF) and acute rejection (AR) are common complications in kidney transplant patients. Objectives: The study evaluated DGF and AR in highly sensitized patients and their effects on kidney function for six months post-transplantation. Methods: We enrolled 95 patients with kidney transplants from living donors who were divided into two groups. Group 1 included 47 highly sensitized patients with panel reactive antibody (PRA) < 20.0% and negative donor-specific antigen, and group 2 included 48 patients with negative PRA. All patients were followed for the state of DGF, AR, and kidney function for six months. Results: Group 1 showed a significantly higher proportion of DGF and AR than group 2 (27.7% versus 2.1%, P < 0.001 and 14.9% versus 2.1%, P = 0.031, respectively). The rates of positive PRA in DGF and AR patients were significantly higher than those in non-DGF and non-AR patients (92.9% versus 42.0%, P < 0.001 and 87.5% versus 46.0%, P = 0.031, respectively). Transplanted kidney function was significantly worse in patients with PRA and DGF and/or AR than in patients with negative PRA and non-DGF and non-AR only in the seventh-day post-transplantation. Conclusions: Kidney transplant in highly sensitized patients with positive PRA was related to the increased ratio of DGF and AR.

scholarly journals An Attempt to Optimize the Outcome of Penetrating Keratoplasty in Congenital Aniridia-Associated Keratopathy (AAK).

2021 ◽  
Author(s):  
Christian Joe Farah ◽  
Fabian Fries ◽  
Lorenz Latta ◽  
Barbara Käsmann-Kellner ◽  
Berthold Seitz
Keyword(s):  
Visual Acuity ◽  
Penetrating Keratoplasty ◽  
Case Series ◽  
Autologous Serum ◽  
Eye Drops ◽  
Logrank Test ◽  
Congenital Aniridia ◽  
Group 2 ◽  
Group 1

Abstract Purpose To propose an optimized microsurgical and medical approach to reduce the risk of complications after penetrating keratoplasty (PKP) in patients with aniridia-associated keratopathy (AAK). Methods Retrospective observational case series of 25 PKP performed in 16 patients with AAK. Preoperative indications were endothelial decompensation and vascularised scars (68%) or graft failure (32%) due to limbal stem cell deficiency. The optimized approach included a combination of a small corneal graft size (around 7.0mm), interrupted 10-0-Nylon sutures, simultaneous AMT as a patch, large bandage contact lens, temporary lateral tarsorrhaphy, postoperative autologous serum eye drops, and systemic immunosuppression. Main outcome measures included: Visual acuity, transplant survival and complications encountered during follow-up of 107 weeks on average. Results A complete modified keratoplasty scheme was used in 10 of 25 PKP (group 1), while at least one of the modifications was missing in the other 15 PKP (group 2). After 8 weeks follow-up, the epithelium was closed in 23 eyes. Visual acuity improved in 19 eyes at 6 months follow-up, and remained stable in 6 eyes. None of the eyes showed a decrease in visual acuity. At the last post-operative follow-up, this visual improvement persisted in 14 eyes and graft survival rate after 156 weeks (3 years) was 69% in group 1 vs. 44% in group 2 (p = 0.39, logrank test). Secondary corneal neovascularisation (8%), scarring (4%), ulcer (4%) or graft rejection (8%) happened mostly in the second group which was missing at least one of the suggested modifications. Conclusions PKP in congenital aniridia must be considered as a high-risk keratoplasty. An optimized therapeutic approach seems to be promising in order to reduce the postoperative complication rate in these most difficult eyes.

Use of Mineral Trioxide Aggregate with or without a Collagen Sponge as an Apical Plug in Teeth with Immature Apices

2021 ◽  
Vol 45 (3) ◽  
pp. 165-170
Author(s):  
Gün Burak Tek ◽  
Gül Keskin
Keyword(s):  
Retrospective Study ◽  
Clinical Outcomes ◽  
Study Design ◽  
Mineral Trioxide Aggregate ◽  
Collagen Sponge ◽  
Protocol Group ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Objective: This retrospective study aimed to evaluate the clinical outcomes of the apical plug performed using MTA with or without collagen sponge in immature anterior maxillary teeth with necrotic pulp. Study design: The study included apical obturation of 20 upper incisor teeth from 18 patients and outcomes of 12-month follow-up. The teeth were divided into 2 groups with 10 cases in each group according to the apexification protocol (Group 1; apical plug with MTA, Group 2; collagen sponge and apical plug with MTA). The artificial apical barrier, approximately 4-mm-thick, was created with MTA in each group. Based on clinical and radiographic criteria, the outcome was assessed using the periapical index (PAI) by 2 calibrated investigators. Results: In this study, 3 of the 6 teeth (50%) in Group 1 and 5 of the 8 teeth (62.5%) in Group 2 healed at the 12-month follow-up. However, there was no statistically significant difference between the groups at the post-treatment follow-up times. Conclusion: The use of collagen as an apical matrix prior to the MTA plug can be suggested due to favorable clinical outcomes.

scholarly journals Surgical Technique and Clinical Outcomes of Osteochondral Autograft Transplantation for Large Osteonecrotic Lesions of the Femoral Condyle With Residual Normal Cartilage: The Eyeglass Technique

2019 ◽  
Vol 7 (10) ◽  
pp. 232596711987244 ◽  
Author(s):  
Hiromitsu Yabumoto ◽  
Yasuaki Nakagawa ◽  
Shogo Mukai
Keyword(s):  
Surgical Technique ◽  
Clinical Outcomes ◽  
Femoral Condyle ◽  
Standard Technique ◽  
Intergroup Difference ◽  
Normal Cartilage ◽  
Osteochondral Autograft ◽  
Group 2 ◽  
Group 1

Background: Osteochondral autograft transplantation (OAT) is usually performed for a defect that is <400 mm2 because of the limitations of autografts. Purpose: To present the surgical technique and clinical outcomes of OAT using the eyeglass technique for large osteonecrotic lesions of the femoral condyle (LOFs) (>400 mm2) with residual normal cartilage. Study Design: Cohort study; Level of evidence, 3. Methods: Cases (group 1) included 15 patients (18 knees) who underwent OAT using the eyeglass technique for LOFs with residual normal cartilage, while controls (group 2) included 11 patients (11 knees) who underwent OAT using the standard technique for small osteonecrotic lesions of the femoral condyle (≤400 mm2). Clinical outcomes were evaluated preoperatively and at the final follow-up (group 1, 56 months; group 2, 48 months) according to the International Knee Documentation Committee (IKDC) objective grade, the IKDC subjective score, and the Japanese Orthopaedic Association (JOA) score. Results: The mean lesion size was 685 mm2 in group 1 and 230 mm2 in group 2. Patients in group 1 had postoperative scores equivalent to those in group 2. The postoperative IKDC subjective scores in group 1 (mean, 86.9) and group 2 (mean, 87.0) showed no significant difference at the final follow-up ( P = .653). For postoperative IKDC objective grades, 83.3% of group 1 and 81.8% of group 2 were graded as “nearly normal” or better, and no significant intergroup difference was found for the IKDC objective grade ( P = .989). Also, no significant intergroup difference was found for the postoperative JOA score (group 1, 93.9; group 2, 81.4; P = .480). Nine second-look arthroscopic procedures were performed in group 1 compared with 4 in group 2, and all patients had plugs that were graded as “nearly normal” or better by the International Cartilage Repair Society classification system. Conclusion: The postoperative results of patients who underwent OAT using the eyeglass technique for large osteonecrotic lesions (>400 mm2) were equivalent to the results of patients who underwent OAT using the standard technique for small osteonecrotic lesions (≤400 mm2).

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