Abstract
Although several prior studies have described the outcomes of osteochondral allograft
(OCA) transplantation for single osteochondral lesions, there is a paucity of comparative
data on outcomes of single versus multiple OCA transplants. We aimed to describe the
initial outcomes of single-plug versus multiple-plug knee OCA transplants at a minimum
of 1 year of follow-up. We hypothesized that there would be no difference in patient-reported
outcome measures (PROMs) between patients undergoing single-plug and multiple-plug
OCA transplants at a minimum of 1 year of follow-up. We retrospectively reviewed the
prospectively collected data of patients undergoing OCA transplantation for large
(>2 cm2 ) osteochondral defects of the knee. Thirty patients who underwent multiple-plug (2 + )
OCA transplants (either single surface using the snowman technique or multi-surface)
were 1:1 age, sex, and body mass index (BMI) matched with 30 patients who underwent
single-plug OCA transplants. PROMs, including the International Knee Documentation
Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Score (KOOS) subscores,
were obtained both preoperatively and at a minimum of 1 year postoperatively. Failure
was defined as a revision OCA or conversion to unicompartmental knee arthroplasty
(UKA) or total knee arthroplasty (TKA). The cohort comprised 30 females (31 affected
left knees), with an average age of 37 ± 10.3 years and median follow-up of 2.0 years
(interquartile range: 1.7–2.5 years). There was a significant increase in PROMs from
the preoperative to the postoperative period for the entire cohort and the single-plug
versus multiple-plug subgroups (p < 0.01). There was no difference between the groups with respect to the percentage
of patients who achieved the minimal clinically important difference (MCID) for each
PROM (p > 0.05). There were two failures, both in the single-plug group, with a mean time
to failure of 3.5 years. There was no difference in the initial outcomes between patients
undergoing single-plug versus multiple-plug OCA transplant at the short-term follow-up.
Level of Evidence: Level IV, case series.
Keywords knee - patella - knee, articular cartilage - knee, general
