The American Journal of Sports Medicine最新文献

{"title":"Thin Flap Trochleoplasty With Medial Patellofemoral Ligament Reconstruction for Recurrent Patellofemoral Instability With High-Grade Trochlear Dysplasia: A Series of 63 Consecutive Cases","authors":"Laurie A. Hiemstra, Alexis Rousseau-Saine, Mark R. Lafave, Sarah Kerslake","doi":"10.1177/03635465251314882","DOIUrl":"https://doi.org/10.1177/03635465251314882","url":null,"abstract":"Background:Trochlear dysplasia is present in 68% to 85% of patients with recurrent lateral patellofemoral instability (LPI) compared with 3% to 6% of healthy controls. Trochlear dysplasia has been associated with medial patellofemoral ligament (MPFL) graft failure and lower quality-of-life (QOL) outcome scores. The correction of trochlear dysplasia with trochleoplasty is indicated in patients with recurrent LPI and high-grade trochlear dysplasia with a trochlear bump and a significant J-sign.Purpose:To assess the clinical and patient-reported outcomes after patella-stabilizing surgery, including thin flap sulcus deepening trochleoplasty, and to explore the influence of pathoanatomic variables on postoperative QOL scores in patients who have undergone patellar stabilization, including trochleoplasty.Study Design:Case series; Level of evidence, 4.Methods:A total of 63 consecutive knees in 46 patients with recurrent LPI and high-grade trochlear dysplasia who underwent MPFL reconstruction with thin flap trochleoplasty were followed for 2 years postoperatively. Clinical outcomes and Banff Patellofemoral Instability Instrument (BPII) 2.0 scores were collected prospectively. The t test was used to determine changes in QOL. Multiple linear regression was conducted to determine significant pathoanatomic variables that affected outcomes after MPFL reconstruction.Results:Overall, 63 knees with a mean follow-up of 32.9 ± 17.0 months (range, 12-84 months) were included. All patients had preoperative high-grade trochlear dysplasia (Dejour type B: 46%; Dejour type D: 54%), with a mean trochlear bump height of 6.1 ± 1.8 mm (range, 3.2-10.5 mm). The BPII 2.0 score increased significantly from preoperatively (29.3 ± 12.4) to postoperatively (71.8 ± 17.4) ( P &lt; .001), with a large effect size (Cohen d = −2.41). There was 1 redislocation (1.6%) and 3 reoperations (4.8%). Persistent apprehension and the J-sign were present in 8.5% and 13.6% of the knees, respectively. Multiple linear regression analysis demonstrated no statistically significant predictive relationship between the 24-month postoperative BPII 2.0 score and the preoperative BPII 2.0 score, tibiofemoral rotation, the Beighton score, or trochlear bump height ( R = 0.47; R<jats:sup>2</jats:sup> = 0.22; F = 5.23; P = .13).Conclusion:Thin flap trochleoplasty combined with MPFL reconstruction in patients with recurrent LPI and high-grade trochlear dysplasia resulted in low redislocation and reoperation rates at a mean of 33 months. Disease-specific QOL scores were statistically significantly improved from preoperatively to postoperatively.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Correction of Coronal and Rotational Deformities of the Femur With Distal Femoral Osteotomy Using Patient-Specific Instrumentation","authors":"Georgios Neopoulos, Lukas Jud, Lazaros Vlachopoulos, Sandro F. Fucentese","doi":"10.1177/03635465251314868","DOIUrl":"https://doi.org/10.1177/03635465251314868","url":null,"abstract":"Background:Distal femoral osteotomy (DFO) can be used to simultaneously correct coronal and rotational deformities. Patient-specific instruments (PSIs) are known to be helpful in such complex osteotomies, but data on surgical accuracy for the combined correction of coronal and rotational deformities of the femur are missing.Purpose:To investigate the radiological results of DFO for simultaneous correction of coronal and rotational deformities using PSIs.Study Design:Case series; Level of evidence, 3.Methods:All included patients underwent DFO (34 patients, 36 knees) using PSIs for combined correction of coronal and rotational deformities. The hip-knee-ankle angle (HKA) was measured in weightbearing long-leg radiographs, and the femoral torsion was assessed using computed tomography scans, both pre- and postoperatively. The achieved corrections of HKA and femoral torsion were determined for each knee, and surgical accuracy was calculated.Results:HKA and femoral torsion changed significantly from preoperatively to postoperatively (from 2.4° ± 3.6° vs 0.1° ± 1.8° [ P &lt; .001] and 31.2° ± 17.2° vs 18.7° ± 7.4° [ P &lt; .001]). The difference from planned to achieved correction was statistically greater for HKA (–2.9° ± 3.8° vs –2.3° ± 3.5°; P = .018) than for femoral torsion (–12.4° ± 11.8° vs –12.3° ± 12.2°; P = .771), which did not reach significance. The accuracies of HKA and femoral torsion correction were 1.1° ± 1° and 2.4° ± 1.9°, respectively.Conclusion:Coronal and rotational deformities of the femur can accurately be corrected simultaneously by a DFO, utilizing PSIs. High accuracy was achieved for the correction of both coronal and rotational deformities, with absolute mean differences from planned to achieved correction of 1.1° and 2.4°, respectively.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"207 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indications for Lateral Extra-articular Tenodesis in Anterior Cruciate Ligament Reconstruction: A Systematic Review","authors":"Jan Zabrzyński, Adam Kwapisz, Jakub Erdmann, Maria Zabrzyńska, Michał Błachowski, Jakub Ohla, Michalina Adamczyk, Maciej Sokołowski, Bartosz Majchrzak, Gazi Huri","doi":"10.1177/03635465241309282","DOIUrl":"https://doi.org/10.1177/03635465241309282","url":null,"abstract":"Background:The anterior cruciate ligament (ACL) is a major sagittal plane stabilizer of the knee joint. Even if anterior laxity can be brought under control by utilizing modern surgical techniques, internal rotational instability may not always be controlled adequately. Various surgical techniques are used to prevent this coronal or rotational instability, such as lateral extra-articular tenodesis (LET). Despite an abundance of articles in recent decades discussing LET in ACL reconstruction, no definitive indicators for extra-articular tenodesis have been described in the literature.Purpose:Given the scarcity of literature assessing the indications in LET, the purpose of this study was to conduct a systematic review of the described indications for this operation in the context of concurrent ACL reconstruction.Study Design:Systematic review; Level of evidence, 4.Methods:We searched PubMed, Cochrane Central, ScienceDirect, Web of Science, and Embase using the following key terms with no limits regarding the year of publication: (extraarticular OR extraarticular) AND (tenodesis OR plasty OR augmentation OR procedure or reconstruction OR reconstructive OR surgical OR surgery OR technique) AND (ACL OR anterior cruciate ligament). We included clinical human studies based on levels of evidence 1 to 4 that were written in English. We excluded studies not written in English, case studies, reviews, letters to editors, conference abstracts, or studies containing incomplete or irrelevant data.Results:The analysis evaluated 29 articles published between 1999 and 2023. We evaluated mostly level 3 (n = 13) and level 4 (n = 12) evidence; however, there were 4 articles with level 1 evidence. The majority of the studies were retrospective (n = 21), although there were prospective studies (n = 8). The mean age of the participants was 24.4 years. The most prevalent indications for LET were high-risk sports (16 articles), medial meniscal repair/excision (11 articles), and pivot-shift test grades 2 and 3 (11 articles).Conclusion:The reviewed articles showed reduced pivoting and laxity, improved clinical outcomes, and decreased revision rates after primary ACL reconstruction. The main frequent and repeated indications for using LET in ACL reconstruction are meniscal surgery, sports activity, and grade 2 and 3 pivoting.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143125367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knee Stability in Remnant-Preserving ACL Reconstruction: Response","authors":"Melissa L. Carpenter, Jorge Chahla","doi":"10.1177/03635465241296835","DOIUrl":"https://doi.org/10.1177/03635465241296835","url":null,"abstract":"","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143125311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Prospective, Randomized Trial of the Modified Jobe Versus Docking Techniques With Gracilis Autograft for Ulnar Collateral Ligament Reconstruction in the Elbow","authors":"Michael C. Ciccotti, Austin M. Looney, Emma E. Johnson, Christopher J. Hadley, Adam Zoga, Levon Nazarian, Michael G. Ciccotti","doi":"10.1177/03635465241305741","DOIUrl":"https://doi.org/10.1177/03635465241305741","url":null,"abstract":"Background:Ulnar collateral ligament (UCL)reconstruction (UCLR) has transformed UCL injury from career-ending to career-interruptive. The most common surgical techniques are the modified Jobe and docking techniques.Purpose/Hypothesis:The purpose of this study was to perform a prospective, randomized comparison of the modified Jobe versus docking techniques in overhead athletes with respect to patient-reported outcomes (PROs), self-reported baseball-specific metrics, imaging, and complications. It was hypothesized that there would be no significant differences between techniques.Study Design:Randomized controlled trial; Level of evidence, 2.Methods:A single-surgeon, single-blinded, prospective, randomized trial was performed comparing the modified Jobe and docking techniques. Patients were blinded to surgical technique. UCLR was performed with uniform gracilis autograft and identical postoperative rehabilitation. Pre- and postoperative PROs (Kerlan-Jobe Orthopaedic Clinic [KJOC] score, Andrews-Timmerman score, and Conway-Jobe score) were obtained. Pre- and postoperative imaging included stress ultrasound (SUS) and magnetic resonance imaging (including magnetic resonance arthrography). Additional information included demographics, anthropometrics, intraoperative data, complications, and self-reported baseball-specific metrics.Results:Eighty patients were randomized, and &gt;80% follow-up was obtained (65/80 [81%]). There were no significant differences with respect to demographics, anthropometrics, preoperative imaging, or preoperative PROs. Surgically, docking had shorter median tourniquet time (91.5 vs 98.0 minutes; P = .001). There were no differences in Andrews-Timmerman score at any time point. Docking demonstrated a higher median KJOC score at 2 years (93.05 vs 79.20; P = .021). There was no difference with respect to return to play (RTP) by the Conway-Jobe scale (80% good to excellent docking vs 69% good to excellent Jobe; P = .501) or time to RTP (13.92 months docking vs 12.85 months Jobe; P = .267). There were no differences in baseball metrics postoperatively. On postoperative SUS, modified Jobe showed greater graft thickness (7.70 vs 6.75 mm; P = .006). Postoperative MRI revealed no differences. There was no difference in complications (Jobe 5.0% vs docking 7.5%; P &gt; .999).Conclusion:The current study identified high rates of good to excellent results with PROs for both techniques, including RTP rates and times. Docking had shorter tourniquet time and higher 2-year KJOC scores. There were no differences in self-reported baseball-specific metrics or postoperative imaging (except graft thickness for modified Jobe by SUS). As the first prospective, randomized trial evaluating the modified Jobe and docking techniques, this study is the definitive substantiation of these two surgical techniques for UCLR. It provides surgeons with confidence to utilize the technique with which they are most comfortable.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"85 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143125348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gimme Shelter","authors":"Brett Owens","doi":"10.1177/03635465251313755","DOIUrl":"https://doi.org/10.1177/03635465251313755","url":null,"abstract":"","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143125312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knee Stability in Remnant-Preserving ACL Reconstruction: Letter to the Editor","authors":"Ruijia Wang, Lingxiao Chen","doi":"10.1177/03635465241296837","DOIUrl":"https://doi.org/10.1177/03635465241296837","url":null,"abstract":"","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143125313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Quantitative Fatty Infiltration Evaluation of the Supraspinatus Muscle: Enhanced Clinical Relevance and Improved Diagnostic Value on Predicting Retear Compared With the Goutallier Classification","authors":"Jianhao Xie, Meng Zhou, Zhe Guo, Yiming Zhu, Chunyan Jiang","doi":"10.1177/03635465251313809","DOIUrl":"https://doi.org/10.1177/03635465251313809","url":null,"abstract":"Background:Preoperative assessment of fatty degeneration is important for managing rotator cuff tears. The Goutallier classification is semiquantitative and observer dependent. Discrepancies among surgeons can be prominent. A quantitative method may improve accuracy and reliability in evaluating the exact percentage of fatty infiltration (Fat%).Hypothesis/Purpose:This study aimed to investigate the correlation between the new quantitative method and the Goutallier classification in assessing fatty infiltration (FI) of the supraspinatus muscle and to explore the use of this method in predicting retear after rotator cuff repair. It was hypothesized that the new method would significantly correlate with the Goutallier classification and be more sensitive to retear.Study Design:Cohort study (diagnosis); Level of evidence; 3.Methods:This study included 105 patients who underwent arthroscopic rotator cuff repair for large to massive tears. All patients underwent routine preoperative and 1-year postoperative magnetic resonance imaging and were divided into 2 groups according to tendon healing. Preoperative quantitative Fat% of the supraspinatus muscle was evaluated based on the signal intensity (SI) of the T1-weighted sequence. The Fat% was calculated using the following equation: SI<jats:sub>supraspinatus</jats:sub> = SI<jats:sub>fat</jats:sub>× Fat% + SI<jats:sub>muscle</jats:sub>× (1 – Fat%). The correlation between the Fat% and the Goutallier grade was determined. Univariate and multivariate analyses were performed to identify the independent risk factors for retear.Results:The mean preoperative Fat% of the supraspinatus muscle was 23.77 ± 15.96. A significant correlation was found between the Fat% and the Goutallier grade of the supraspinatus muscle ( R = 0.655; P &lt; .001). The overall retear rate was 21.9%; however, functional status significantly improved regardless of cuff healing. Multivariate analysis identified the Fat% ( P = .005) and the modified Patte classification ( P = .003) as independent risk factors of retear. The receiver operating characteristic curves showed that the cutoff value of Fat% for predicting retear was 33.2%. Fat% &gt;33.2% possessed superior diagnostic accuracy (79.0%), Youden index (0.513), and positive and negative predictive values (51.6% and 90.5%, respectively) compared with the Goutallier grades.Conclusion:Although the quantitative method for assessing Fat% of the supraspinatus muscle significantly correlated with the Goutallier classification, the quantitative method is more clinically relevant to retear. Fat% of the supraspinatus muscle &gt;33.2% possessed higher diagnostic value than the Goutallier grades in predicting retear.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143072481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Outcomes of Ulnar Collateral Ligament Repair With Internal Brace Versus Ulnar Collateral Ligament Reconstruction in Competitive Athletes","authors":"Jeffrey R. Dugas, Ryan J. Froom, Eric A. Mussell, Sydney M. Carlson, Anna E. Crawford, Graham E. Tulowitzky, Travis Dias, Kevin E. Wilk, Arsh N. Patel, Ariel L. Kidwell-Chandler, Michael K. Ryan, Andrew W. Atkinson, Andrew H. Manush, Marcus A. Rothermich, Matthew P. Ithurburn, Benton A. Emblom, E. Lyle Cain","doi":"10.1177/03635465251314054","DOIUrl":"https://doi.org/10.1177/03635465251314054","url":null,"abstract":"Background:The increasing prevalence of ulnar collateral ligament (UCL) injuries, particularly in young athletes, necessitates optimization of treatment options. The introduction of UCL repair with internal bracing offers an exciting alternative to traditional UCL reconstruction.Purpose:To compare midterm outcomes between UCL repair with internal bracing and UCL reconstruction in competitive athletes.Study Design:Cohort study; Level of evidence, 3.Methods:The authors identified competitive athletes who underwent primary UCL repair with internal bracing or UCL reconstruction between 2013 and 2021 and were at least 2 years postsurgery. To have qualified for repair, patients must have shown complete or partial UCL avulsion from the sublime tubercle or medial epicondyle. Relevant patient, injury, operative, and revision surgery data were collected via chart review. Preoperative American Shoulder and Elbow Surgeons Elbow assessment form (ASES-E), Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow (KJOC), and Andrews-Carson scores were obtained from an ongoing data repository. ASES-E, KJOC, and Andrews-Carson scores, and return-to-sport (RTS) data were collected at follow-up. Linear regression modeling controlling for relevant covariates was utilized to compare patient-reported outcome (PRO) scores between groups. Proportions of athletes who successfully returned to sport and proportions of subsequent revision procedures between groups were compared using chi-square tests. Lastly, for those with baseline questionnaire data, the authors compared magnitude of change between preoperative and postoperative scores between groups using linear regression modeling with baseline scores and follow-up time as the covariates, and follow-up scores as the dependent variable.Results:A total of 461 athletes were eligible for inclusion with complete clinical and outcome data available (mean age at surgery, 19.1 years; 92% male). The UCL repair group had a significantly shorter follow-up time than the UCL reconstruction group (4.4 vs 6.3 years; P &lt; .01). When controlling for follow-up time, the groups did not differ in ASES-E, KJOC, or Andrews-Carson scores at follow-up. There was no significant difference in proportion of revisions between UCL repair (9%) and UCL reconstruction (8%) ( P = .77). Of the 268 athletes with complete follow-up in the repair group, 247 attempted to return to their preinjury sport, and 241 (98%) were able to RTS. Six athletes reported that they were unable to RTS due to limitations from their surgery. Of the 155 athletes with follow-up in the reconstruction group, 147 attempted to return to their preinjury sport; 145 (99%) were able to successfully RTS, and 2 were unable to return due to limitations from their surgery. The 2 groups, repair with internal brace versus reconstruction, did not statistically differ in the proportions that returned to preinjury sport ( P = .20) but did differ regarding time in months to return to practice (6.7 ± 3","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143072480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midterm Survivorship and Clinical Outcomes in Fresh Osteochondral Allograft Transplantation for the Treatment of Large Bipolar Lesions of the Knee","authors":"Tony S. Bouz, Tim Wang, Jordan K. Penn, Julie C. McCauley, William D. Bugbee","doi":"10.1177/03635465241313139","DOIUrl":"https://doi.org/10.1177/03635465241313139","url":null,"abstract":"Background:Fresh osteochondral allograft (OCA) transplantation is an established treatment option for patients with chondral or osteochondral lesions of the knee. Predictably positive outcomes are seen in situations of focal or isolated cartilage defects. However, OCA transplantation may also be performed in more complex joint salvage situations in young patients.Purpose:To evaluate survivorship and outcomes in patients who underwent OCA transplantation for large bipolar lesions of the knee.Study Design:Case series; Level of evidence, 4.Methods:Fresh OCAs were implanted for bipolar chondral lesions in 86 patients (89 knees) between 1983 and 2020. A total of 37 male and 52 female knees with a mean patient age of 37.9 years (range, 14.5-66.0 years) were treated. Surgical indications included degenerative chondral lesions, osteoarthritis, osteochondritis dissecans, traumatic chondral injuries, and previous failed OCAs. The clinical evaluation included the modified Merle d’Aubigné-Postel score, International Knee Documentation Committee (IKDC) score, and Knee Injury and Osteoarthritis Outcome Score (KOOS). Outcomes were collected during outpatient clinic visits or via mail. The minimum follow-up was 2 years. Additional procedures after OCA transplantation were documented. OCA failure was defined as a reoperation that involved removal of the allograft.Results:There were 81 knees (91.0%) that had undergone previous surgery, with a mean of 3.2 previous procedures (range, 1-11). The mean treated defect surface area was 16.7 cm<jats:sup>2</jats:sup>. Graft failure occurred in 31 knees (34.8%). Reoperations (including failures) occurred in 46 knees (51.7%). The mean time to failure was 4.8 years. Survivorship of the bipolar OCA was 73.8% at 5 years, 66.6% at 10 years, and 58.9% at 15 years. Among the 58 knees (65.2%) in which the OCA was still in situ, the mean follow-up was 11.3 years (range, 2.1-27.6 years). The mean modified Merle d’Aubigné-Postel score improved from 12.4 to 14.8 points; 64.3% of knees (36/56 with available data) were considered successful with a score ≥15. The mean IKDC pain score improved from 6.3 to 4.0, and the mean IKDC function score improved from 2.9 to 6.2. The KOOS symptoms, pain, activities of daily living, sports/recreation, and quality of life subscores all increased postoperatively by a mean of 19.7, 25.9, 27.1, 35.4, and 36.4, respectively.Conclusion:OCA transplantation is a salvage treatment option for large bipolar cartilage lesions of the knee with acceptable survivorship and significant clinical improvement in a challenging patient population.","PeriodicalId":517411,"journal":{"name":"The American Journal of Sports Medicine","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}