124: AAOS Annual Meeting Updates: Patellofemoral Osteochondral Allograft Transplantation

Our next AAOS 2025 Annual Meeting poster is titled Mid-term Follow-up of Patellofemoral Osteochondral Allograft Transplantation. This study was performed by Dr. Bill Bugbee and his team at the Scripps Clinic. Dr. Bugbee was a guest on our show back in November 2023.  That is episode 59 and 60, if you want to go check it out.  In that episode, we discussed osteochondral allograft transplantation for various cartilage defects of the knee, including medial and lateral tibiofemoral, which are the more common locations for OCA transplantation.  This study focuses specifically on outcomes of OCA transplantation for patellofemoral cartilage defects.This study identified 127 patients undergoing OCA transplantation in the patellofemoral compartment – 51 to the patella, 47 to the trochlea and 29 bipolar patella and trochlea.  The most common indication was a degenerative cartilage lesion at 47%, followed by a traumatic cartilage injury at 25% and osteochondritis dissecans at 15%.  All patients had a minimum follow-up of 2 years.  OCA failure was defined as any reoperation that involved removal of the allograft.  Patient reported outcomes were also assessed pre-op and post-op, including the IKDC score and KOOS score.So, what did this study find?  First, reoperations occurred in 39% of the knees.  Rate of reoperation was not statistically significant between patella, trochlea and bipolar grafts.  Second, OCA failures occurred in 16% of the knees at a median 4.4 years following the index surgery, and the most common revision procedure was arthroplasty.  Although it did not reach statistical significance, trochlear grafts had a lower failure rate of 9% compared to patellar grafts at 20% and bipolar grafts at 21%.Overall, graft survivorship at 5 and 10 years was 91% and 82%, respectively.  Patients with patellar, trochlear and bipolar grafts all had significant improvement in IKDC scores and KOOS scores from preop to the latest follow-up and no statistically significant differences were observed between the groups.  Overall, 77% of patients reported being satisfied with the results of the OCA transplantation with no statistically significant differences in satisfaction between the groups.Also check out:Episode 91: Dr. Tom DeBerardino 0n Advances in Patellofemoral Cartilage Restoration