Arturo M De Pena, Marcos R Gonzalez, Joseph J Connolly, Santiago A Lozano-Calderon
{"title":"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。","authors":"Arturo M De Pena, Marcos R Gonzalez, Joseph J Connolly, Santiago A Lozano-Calderon","doi":"10.1002/jso.70081","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":17111,"journal":{"name":"Journal of Surgical Oncology","volume":" ","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Long-Term Functional Outcomes and Modes of Failure of Fresh Frozen Hemicondylar Allografts: A Retrospective Cohort Study.\",\"authors\":\"Arturo M De Pena, Marcos R Gonzalez, Joseph J Connolly, Santiago A Lozano-Calderon\",\"doi\":\"10.1002/jso.70081\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p><p><strong>Level of evidence: </strong>Level IV.</p>\",\"PeriodicalId\":17111,\"journal\":{\"name\":\"Journal of Surgical Oncology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-09-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Surgical Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jso.70081\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Surgical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jso.70081","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
Long-Term Functional Outcomes and Modes of Failure of Fresh Frozen Hemicondylar Allografts: A Retrospective Cohort Study.
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.
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.