Research Shows OCA Is Effective for Certain Knee Cartilage Repairs
Isolated femoral condyle lesions account for 75% of the cartilage repair procedures performed in the knee joint, and surgeons have a variety of techniques to consider as part of surgical treatment. Osteochondral allograft transplantation (OCA) is a valuable and successful approach for this condition, as described by research presented at the American Orthopaedic Society for Sports Medicine’s Specialty Day in New Orleans.
“Our study demonstrated that the modern OCA transplantation technique, which utilizes thin, dowel type grafts, was very effective in treating patients with femoral condyle cartilage lesions,” said lead author Luís E. Tírico, MD, who is currently with the University of Sao Paulo in Sao Paulo, Brazil. He served as the research fellow and lead author on the presentation under William Bugbee, MD, Director of Clinical Research and Head of the Scripps Cartilage Restoration and Transplant Program at Scripps Clinic in La Jolla, CA.
“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 study – the largest reported cohort of isolated femoral condyle lesions treated with the modern, dowel technique for OCA transplantation – included 187 patients (200 knees) who underwent OCA transplantation between June 1999 and August 2014. The following improvements in knee scores were seen at a minimum follow-up of 2 years and an average of 6.7 years:
- International Knee Documentation Committee total scores, from 43.7 to 76.2 on average
- Knee injury and Osteoarthritis Outcome Score (KOOS) for pain, from 66.5 to 85.3
- KOOS for activities of daily living, from 74.5 to 91.1
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 modern technique of OCA transplantation for treating isolated femoral condyle lesions offers patient better results over other cartilage repair procedures,” Dr. Tírico said.
“These results appear to be equal or superior to any other cartilage repair procedure for the treatment of femoral condyle lesions and lead us to consider whether fresh OCA should be viewed as the current gold standard in cartilage repair for focal femoral condyle lesions.”
Tírico LE, McCauley JC, Pulido P, Bugbee W. Modern Osteochondral Allograft Transplantation: The “Gold Standard” for Femoral Condyle Cartilage Repair? (Paper 04). Presented at the 2018 American Orthopaedic Society for Sports Medicine/Arthroscopy Association of North America Specialty Day, March 10, 2018, in New Orleans.