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Erschienen in: Current Reviews in Musculoskeletal Medicine 2/2019

29.04.2019 | Outcomes Research in Orthopedics (O Ayeni, Section Editor)

Outcomes Associated with Return to Sports Following Osteochondral Allograft Transplant in the Knee: a Scoping Review

verfasst von: John A. Grant

Erschienen in: Current Reviews in Musculoskeletal Medicine | Ausgabe 2/2019

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Abstract

Purpose of Review

The purposes of this review were to report the currently validated outcomes for OCA transplant patients, discuss the benefits and challenges associated with “return to sports” as an outcome measure, and summarize the currently available data on patients’ ability to return to sports after OCA transplant.

Recent Findings

College athletes may take less time than professionals to return to basketball, but there are many factors that can influence this timeframe. Player productivity is decreased ~ 40% and future career length is only 1 to 2 years following return to play. When evaluating all OCA transplant patients, 75–88% of patients return to sport and 38–80% return to their previous level of play at approximately 8–10 months following surgery. Overall graft failure rates are low (0–9.4%) but are based on limited short- to medium-term data.

Summary

Data on the return to professional and college sports after OCA transplant is limited. Surgeons should consider collecting patient outcomes across multiple domains and contributing data to aggregate databases to allow for better quality outcome data to be reported.
Fußnoten
1
AMIC: Autologous Matrix-Induced Chondrogenesis
 
2
MACI: Matrix-Associated Autologous Chondrocyte Implantation
 
3
International Knee Documental Committee (IKDC) score [35]
 
4
Knee Injury and Osteoathritis Outcome Score (KOOS) [36]
 
Literatur
1.
Zurück zum Zitat Messner K, Gillquist J. Cartilage repair. A critical review. Acta Orthop Scand. 1996;67(5):523–9.CrossRefPubMed Messner K, Gillquist J. Cartilage repair. A critical review. Acta Orthop Scand. 1996;67(5):523–9.CrossRefPubMed
4.
Zurück zum Zitat Curl WW, Krome J, Gordon ES, Rushing J, Smith BP, Poehling GG. Cartilage injuries: a review of 31,516 knee arthroscopies. Arthroscopy. 1997;13(4):456–60.CrossRefPubMed Curl WW, Krome J, Gordon ES, Rushing J, Smith BP, Poehling GG. Cartilage injuries: a review of 31,516 knee arthroscopies. Arthroscopy. 1997;13(4):456–60.CrossRefPubMed
6.
Zurück zum Zitat Johnson LL. Arthroscopic abrasion arthroplasty: a review. Clin Orthop Relat Res. 2001;391 Suppl:S306–17.CrossRef Johnson LL. Arthroscopic abrasion arthroplasty: a review. Clin Orthop Relat Res. 2001;391 Suppl:S306–17.CrossRef
8.
Zurück zum Zitat Bertho P, Pauvert A, Pouderoux T, Robert H, Orthopaedics, Traumatology Society of Western F. treatment of large deep osteochondritis lesions of the knee by autologous matrix-induced chondrogenesis (AMIC): preliminary results in 13 patients. Orthop Traumatol Surg Res 2018;104(5):695–700. doi:https://doi.org/10.1016/j.otsr.2018.05.008. Bertho P, Pauvert A, Pouderoux T, Robert H, Orthopaedics, Traumatology Society of Western F. treatment of large deep osteochondritis lesions of the knee by autologous matrix-induced chondrogenesis (AMIC): preliminary results in 13 patients. Orthop Traumatol Surg Res 2018;104(5):695–700. doi:https://​doi.​org/​10.​1016/​j.​otsr.​2018.​05.​008.
11.
18.
Zurück zum Zitat • Familiari F, Cinque ME, Chahla J, Godin JA, Olesen ML, Moatshe G, LaPrade RF Clinical outcomes and failure rates of osteochondral allograft transplantation in the knee: a systematic review. Am J Sports Med 2017:363546517732531. doi:https://doi.org/10.1177/0363546517732531 . This systematic review reports on the short- and long-term survival of OCA transplants in the knee. The clinical outcomes and risk factors for failure in this patient population are discussed, 46, 3541, 3549. • Familiari F, Cinque ME, Chahla J, Godin JA, Olesen ML, Moatshe G, LaPrade RF Clinical outcomes and failure rates of osteochondral allograft transplantation in the knee: a systematic review. Am J Sports Med 2017:363546517732531. doi:https://​doi.​org/​10.​1177/​0363546517732531​ . This systematic review reports on the short- and long-term survival of OCA transplants in the knee. The clinical outcomes and risk factors for failure in this patient population are discussed, 46, 3541, 3549.
26.
Zurück zum Zitat Stahl R, Luke A, Ma CB, Krug R, Steinbach L, Majumdar S, et al. Prevalence of pathologic findings in asymptomatic knees of marathon runners before and after a competition in comparison with physically active subjects-a 3.0 T magnetic resonance imaging study. Skelet Radiol. 2008;37(7):627–38. https://doi.org/10.1007/s00256-008-0491-y.CrossRef Stahl R, Luke A, Ma CB, Krug R, Steinbach L, Majumdar S, et al. Prevalence of pathologic findings in asymptomatic knees of marathon runners before and after a competition in comparison with physically active subjects-a 3.0 T magnetic resonance imaging study. Skelet Radiol. 2008;37(7):627–38. https://​doi.​org/​10.​1007/​s00256-008-0491-y.CrossRef
27.
Zurück zum Zitat •• Balazs GC, Wang D, Burge AJ, Sinatro AL, Wong AC, Williams RJ. 3rd. Return to Play Among Elite Basketball Players After Osteochondral Allograft Transplantation of Full-Thickness Cartilage Lesions. Orthop J Sports Med. 2018;6(7):2325967118786941. https://doi.org/10.1177/2325967118786941 This case series reports on the return to sport outcomes of college and professional basketball players who underwent OCA transplant of the knee. While the numbers are limited, it presents data on the timing for return to sport and the player productivity levels upon their return. CrossRefPubMedPubMedCentral •• Balazs GC, Wang D, Burge AJ, Sinatro AL, Wong AC, Williams RJ. 3rd. Return to Play Among Elite Basketball Players After Osteochondral Allograft Transplantation of Full-Thickness Cartilage Lesions. Orthop J Sports Med. 2018;6(7):2325967118786941. https://​doi.​org/​10.​1177/​2325967118786941​ This case series reports on the return to sport outcomes of college and professional basketball players who underwent OCA transplant of the knee. While the numbers are limited, it presents data on the timing for return to sport and the player productivity levels upon their return. CrossRefPubMedPubMedCentral
30.
Zurück zum Zitat •• MA MC, Meyer MA, Weber AE, Levy DM, Tilton AK, Yanke AB, et al. Can competitive athletes return to high-level play after osteochondral allograft transplantation of the knee? Arthroscopy. 2017;33(9):1712–7. https://doi.org/10.1016/j.arthro.2017.03.020 . This series reports on the return to sports outomes of 13 high school and college athletes following OCA transplant in the knee. The timing for return to sports, as well as the barriers to return to the previous level of sports are discussed. CrossRef •• MA MC, Meyer MA, Weber AE, Levy DM, Tilton AK, Yanke AB, et al. Can competitive athletes return to high-level play after osteochondral allograft transplantation of the knee? Arthroscopy. 2017;33(9):1712–7. https://​doi.​org/​10.​1016/​j.​arthro.​2017.​03.​020 . This series reports on the return to sports outomes of 13 high school and college athletes following OCA transplant in the knee. The timing for return to sports, as well as the barriers to return to the previous level of sports are discussed. CrossRef
31.
Zurück zum Zitat •• Nielsen ES, JC MC, Pulido PA, Bugbee WD. Return to Sport and Recreational Activity After Osteochondral Allograft Transplantation in the Knee. Am J Sports Med. 2017;45(7):1608–14. https://doi.org/10.1177/0363546517694857. This is the largest series reporting return to sports and activity outcomes following osteochondral allograft transplant in the knee. It includes patients with a wide range of activity levels but does not specifically note the inclusion of college or professional athletes. CrossRefPubMed •• Nielsen ES, JC MC, Pulido PA, Bugbee WD. Return to Sport and Recreational Activity After Osteochondral Allograft Transplantation in the Knee. Am J Sports Med. 2017;45(7):1608–14. https://​doi.​org/​10.​1177/​0363546517694857​. This is the largest series reporting return to sports and activity outcomes following osteochondral allograft transplant in the knee. It includes patients with a wide range of activity levels but does not specifically note the inclusion of college or professional athletes. CrossRefPubMed
32.
Zurück zum Zitat • Makhni EC, Meyer MA, Saltzman BM, Cole BJ. Comprehensiveness of Outcome Reporting in Studies of Articular Cartilage Defects of the Knee. Arthroscopy. 2016;32(10):2133–9. https://doi.org/10.1016/j.arthro.2016.04.009 This study reports on the wide range of outcome measures used in studies of patients undergoing cartilage restoration procedures. The authors propose six domains of patient outcomes that should be included in any study reporting the outcomes of cartilage restoration procedures. CrossRefPubMed • Makhni EC, Meyer MA, Saltzman BM, Cole BJ. Comprehensiveness of Outcome Reporting in Studies of Articular Cartilage Defects of the Knee. Arthroscopy. 2016;32(10):2133–9. https://​doi.​org/​10.​1016/​j.​arthro.​2016.​04.​009 This study reports on the wide range of outcome measures used in studies of patients undergoing cartilage restoration procedures. The authors propose six domains of patient outcomes that should be included in any study reporting the outcomes of cartilage restoration procedures. CrossRefPubMed
38.
Zurück zum Zitat Greco NJ, Anderson AF, Mann BJ, Cole BJ, Farr J, Nissen CW, et al. Responsiveness of the international knee documentation committee subjective knee form in comparison to the Western Ontario and McMaster universities osteoarthritis index, modified Cincinnati knee rating system, and short form 36 in patients with focal articular cartilage defects. Am J Sports Med. 2010;38(5):891–902. https://doi.org/10.1177/0363546509354163.CrossRefPubMed Greco NJ, Anderson AF, Mann BJ, Cole BJ, Farr J, Nissen CW, et al. Responsiveness of the international knee documentation committee subjective knee form in comparison to the Western Ontario and McMaster universities osteoarthritis index, modified Cincinnati knee rating system, and short form 36 in patients with focal articular cartilage defects. Am J Sports Med. 2010;38(5):891–902. https://​doi.​org/​10.​1177/​0363546509354163​.CrossRefPubMed
39.
Zurück zum Zitat Kocher MS, Steadman JR, Briggs KK, Sterett WI, Hawkins RJ. Reliability, validity, and responsiveness of the Lysholm knee scale for various chondral disorders of the knee. J Bone Joint Surg Am. 2004;86-A(6):1139–45.CrossRef Kocher MS, Steadman JR, Briggs KK, Sterett WI, Hawkins RJ. Reliability, validity, and responsiveness of the Lysholm knee scale for various chondral disorders of the knee. J Bone Joint Surg Am. 2004;86-A(6):1139–45.CrossRef
41.
Zurück zum Zitat Early S, Tirico LEP, Pulido PA, McCauley JC, Bugbee WD. Long-term retrospective follow-up of fresh osteochondral allograft transplantation for steroid-associated osteonecrosis of the femoral condyles. Cartilage. 2018:1947603518809399. https://doi.org/10.1177/1947603518809399. Early S, Tirico LEP, Pulido PA, McCauley JC, Bugbee WD. Long-term retrospective follow-up of fresh osteochondral allograft transplantation for steroid-associated osteonecrosis of the femoral condyles. Cartilage. 2018:1947603518809399. https://​doi.​org/​10.​1177/​1947603518809399​.
42.
Zurück zum Zitat Meyers MH, Akeson W, Convery FR. Resurfacing of the knee with fresh osteochondral allograft. J Bone Joint Surg Am. 1989;71(5):704–13.CrossRefPubMed Meyers MH, Akeson W, Convery FR. Resurfacing of the knee with fresh osteochondral allograft. J Bone Joint Surg Am. 1989;71(5):704–13.CrossRefPubMed
44.
Zurück zum Zitat Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1985;(198):43–9. Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthop Relat Res. 1985;(198):43–9.
48.
Zurück zum Zitat • Krych AJ, Pareek A, King AH, Johnson NR, Stuart MJ, Williams RJ. 3rd. Return to sport after the surgical management of articular cartilage lesions in the knee: a meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2017;25(1180):3186–96. https://doi.org/10.1007/s00167-016-4262-3 This study reviews available return to sports data across a number of different cartilage restoration procedures. This allows for a comparison of outcomes across these procedures. The data on OCA transplant is limited. CrossRefPubMed • Krych AJ, Pareek A, King AH, Johnson NR, Stuart MJ, Williams RJ. 3rd. Return to sport after the surgical management of articular cartilage lesions in the knee: a meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2017;25(1180):3186–96. https://​doi.​org/​10.​1007/​s00167-016-4262-3 This study reviews available return to sports data across a number of different cartilage restoration procedures. This allows for a comparison of outcomes across these procedures. The data on OCA transplant is limited. CrossRefPubMed
55.
Zurück zum Zitat Jack RA, 2nd, Sochacki KR, Navarro SM, McCulloch PC, Lintner DM, Harris JD. Performance and return to sport after clavicle open reduction and internal fixation in National Football League Players. Orthop J Sports Med 2017;5(8):2325967117720677. doi:https://doi.org/10.1177/2325967117720677. Jack RA, 2nd, Sochacki KR, Navarro SM, McCulloch PC, Lintner DM, Harris JD. Performance and return to sport after clavicle open reduction and internal fixation in National Football League Players. Orthop J Sports Med 2017;5(8):2325967117720677. doi:https://​doi.​org/​10.​1177/​2325967117720677​.
Metadaten
Titel
Outcomes Associated with Return to Sports Following Osteochondral Allograft Transplant in the Knee: a Scoping Review
verfasst von
John A. Grant
Publikationsdatum
29.04.2019
Verlag
Springer US
Erschienen in
Current Reviews in Musculoskeletal Medicine / Ausgabe 2/2019
Elektronische ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-019-09557-3

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