Long-Term Functional Outcomes and Modes of Failure of Fresh Frozen Hemicondylar Allografts: A Retrospective Cohort Study

IF 1.9 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology Pub Date : 2025-09-09 DOI:10.1002/jso.70081

Arturo M. De Pena, Marcos R. Gonzalez, Joseph J. Connolly, Santiago A. Lozano-Calderon

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引用次数: 0

Abstract

Background

Hemicondylar fresh frozen allografts address partial knee defects while preserving native anatomy and bone stock. This study evaluated long-term survival, failure modes, and functional outcomes following hemicondylar reconstruction.

Methods

We conducted a retrospective analysis of hemicondylar fresh frozen allograft reconstructions. Allograft failure was assessed using the Henderson classification and osteoarthritis via Kellgren–Lawrence classification. Functional outcomes were evaluated using MSTS scores and patient-reported measures, with radiographic evaluation performed preoperatively and at 1, 2, 5, and 10 years postoperatively.

Results

A total of 17 patients (13 femoral, 4 tibial allografts) with a median age of 29 years and a median follow-up of 16.9 years were included. Four patients (24%) experienced allograft failure, including two structural failures, one infection, and one soft-tissue failure. Overall allograft survival was 87.5% at 1 year, 80.8% at 2 years, and 74% at 5–20 years, with a median MSTS score of 21/30. While all patients developed progressive osteoarthritis, only six required total knee arthroplasty for symptomatic arthritis rather than allograft failure.

Conclusion

Hemicondylar allografts demonstrate acceptable long-term survival and functional outcomes, with progressive osteoarthritis/chondrolysis representing expected evolution rather than treatment failure. Structural collapse remains the predominant failure mechanism requiring removal. These findings support hemicondylar allografts as viable reconstructive options for selected patients.

Level of Evidence

Level IV.

Abstract Image

查看原文本刊更多论文

新鲜冷冻半髁同种异体移植物的长期功能结局和失败模式：一项回顾性队列研究。

背景：半髁新鲜冷冻同种异体移植在保留原有解剖结构和骨存量的同时解决部分膝关节缺损。本研究评估了半髁重建后的长期生存、失败模式和功能结果。方法：对半髁新鲜冷冻同种异体移植物重建进行回顾性分析。同种异体移植失败采用亨德森分类，骨关节炎采用kelgren - lawrence分类。使用MSTS评分和患者报告的测量方法评估功能结果，并在术前和术后1、2、5和10年进行影像学评估。结果：共纳入17例患者（13例股骨异体移植，4例胫骨异体移植），中位年龄29岁，中位随访16.9年。4例患者（24%）出现同种异体移植失败，包括2例结构失败，1例感染和1例软组织失败。总体同种异体移植1年生存率为87.5%，2年生存率为80.8%，5-20年生存率为74%，中位MSTS评分为21/30。虽然所有患者都发展为进行性骨关节炎，但只有6例患者因症状性关节炎而非同种异体移植失败而需要全膝关节置换术。结论：半髁异体移植物具有可接受的长期生存和功能结果，进行性骨关节炎/软骨溶解代表预期的进化而不是治疗失败。结构坍塌仍然是主要的破坏机制，需要去除。这些发现支持半髁异体移植物作为可行的重建选择，为选定的患者。证据等级：四级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Surgical Oncology 医学-外科

CiteScore

4.70

自引率

4.00%

发文量

367

审稿时长

2 months

期刊介绍： The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.