Arthroscopy: The Journal of Arthroscopic & Related Surgery
Systematic ReviewOutcomes of Osteochondral Allograft Transplantation in the Knee
Section snippets
Literature Search
With the aid of an experienced librarian, we searched PubMed (1948 to week 2 of July 2012), Medline (1946 to week 1 of July 2102), EMBASE (1947 to week 27 of 2012), and the Cochrane Central Register of Controlled Trials (to week 2 of July 2012). This was performed using the following key words: (knee) AND (cartilage OR chondral OR osteochondral) AND (transplant*) AND (allograft). General search terms were used to prevent the possibility of missing relevant studies. The references of all
Results
The search results are summarized in Fig 1. Approximately 144 articles from Medline, 168 articles from EMBASE, 3 articles from the Cochrane Central Register of Controlled Trials, and 389 articles from PubMed were cited over a 64-year period (1948 to 2012), for a total of 704 articles. After duplicates were removed, 441 articles remained. After titles were reviewed and excluded for the following, 186 articles remained: sites unrelated to the knee (e.g., shoulder, talus, or hip), isolated
Discussion
Since Gross et al.29 popularized the concept of osteochondral allograft transplantation in the mid 1970s, there has been increasing attention on this cartilage restoration technique for managing patients with both focal and diffuse (single-compartment) osteochondral defects in the knee.30 Our systematic review involved a qualitative synthesis of 19 Level IV case series over a period of approximately 30 years. Given the heterogeneity of clinical outcome measures used across studies and over
Conclusions
Osteochondral allograft transplantation for focal and diffuse (single-compartment) chondral defects results in predictably favorable outcomes and high satisfaction rates at intermediate follow-up. Patients with OCD, traumatic and idiopathic etiologies have more favorable outcomes, as do younger patients with unipolar lesions and short symptom duration. Future studies should include comparative control groups and use established outcome instruments that will allow for pooling of data across
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The authors report that they have no conflicts of interest in the authorship and publication of this article.