Lower 3- and 6-month postoperative patient-reported outcome measures are associated with treatment failure 2 years following osteochondral allograft transplantation in the knee

IF 5.5 2区医学 Q1 ORTHOPEDICS

Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2026-09-29 Epub Date: 2025-10-27 DOI:10.1002/ksa.70105

Kylee Rucinski, James P. Stannard, Clayton W. Nuelle, Cory R. Crecelius, Renee Stucky, James L. Cook

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引用次数: 0

Abstract

Purpose

The reliability of patient-reported outcome measures (PROMs) as a predictive tool for delayed recovery at 2 years and long-term outcomes following osteochondral allograft transplantation (OCAT) remains uncertain. The objective of this study was to evaluate baseline and 3- to 6-month PROMs for association with 2-year treatment outcomes in primary OCAT patients.

Methods

Patients were prospectively enrolled in a dedicated OCAT registry at a single institution. Preoperative, 3-, 6-month and annual PROMs for function, pain and global health were analysed for associations with recovery and treatment failure, defined as conversion to a total knee arthroplasty (TKA) or revision surgery within 2 years.

Results

Two hundred and seventeen primary OCAT patients were included for analyses; 34 patients experienced treatment failure with 8 undergoing revision and 26 undergoing TKA at a mean timepoint of 15.5 months. Changes in PROMIS Physical Health, PROMIS Physical Function and PROMIS Pain Interference scores from preoperative status were significantly different between 2-year success versus failure cohorts. Absence of mental health history (odds ratio [OR] 2.9, p = 0.033) and lower preoperative International Knee Documentation Committee (IKDC) scores (p = 0.001) were associated with meeting visual analog scale and IKDC minimal clinically important differences at 1 year. Male sex (p = 0.055), nonadherence (p ≤ 0.001, OR: 4.03) and surgery type (tibiofemoral bipolar) (<0.001, OR: 11.3) were significantly associated with increased risk for treatment failure.

Conclusion

Preoperative and 3–6 months PROMs may be useful for identifying patients at-risk for delayed recovery or early failure 2 years following OCAT in the knee in combination with other known risk factors. These findings have significant implications for shared decision-making regarding OCAT indications, timing, patient education and expectations.

Level of Evidence

Level III, cross-sectional analysis of prospectively collected registry data.

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术后3个月和6个月患者报告的结果与膝关节同种异体骨软骨移植2年后治疗失败相关。

目的：患者报告的预后指标（PROMs）作为异体骨软骨移植（OCAT）后2年延迟恢复和长期预后的预测工具的可靠性仍不确定。本研究的目的是评估基线和3至6个月的PROMs与原发性OCAT患者2年治疗结果的关系。方法：前瞻性地将患者纳入单一机构的专用OCAT登记处。分析术前、3个月、6个月和年度功能、疼痛和整体健康的PROMs与恢复和治疗失败的关系，治疗失败的定义为2年内转全膝关节置换术（TKA）或翻修手术。结果：217例原发性OCAT患者纳入分析；34例患者治疗失败，8例接受翻修，26例接受TKA，平均时间为15.5个月。术前状态的PROMIS身体健康、PROMIS身体功能和PROMIS疼痛干扰评分的变化在2年成功组和失败组之间有显著差异。无精神病史（比值比[OR] 2.9, p = 0.033）和术前较低的国际膝关节文献委员会（IKDC）评分（p = 0.001）与1年时符合视觉模拟量表和IKDC最小临床重要差异相关。男性（p = 0.055）、不依从性（p≤0.001,OR: 4.03）和手术类型（胫股双相）(结论：术前和3-6个月PROMs可能有助于识别合并其他已知危险因素的膝关节OCAT术后2年有延迟恢复或早期衰竭风险的患者。这些发现对OCAT适应症、时机、患者教育和期望的共同决策具有重要意义。证据水平：III级，前瞻性收集的注册表数据的横断面分析。

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

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).