title: The Use of Osteochondral Allograft Transplantation for Primary Treatment of Cartilage Lesions in the Knee.
abstract: OBJECTIVE
  To assess the outcome of osteochondral allograft (OCA) transplantation as the primary treatment for cartilage injury in patients with no previous surgical treatment.
  
  
  METHODS
  Case series. Patients were identified in our outcomes database. Patients undergoing primary OCA transplantation with no prior surgical treatment and a minimum of 2 years follow-up were selected. Pain and function were evaluated preoperatively and postoperatively. Patient satisfaction was assessed. Reoperations following OCA transplantation were captured. Failure was defined as revision OCA or conversion to arthroplasty.
  
  
  RESULTS
  Fifty-five patients (61 knees) were included in the analysis. The study consisted of 30 males and 25 females (mean age = 32.9 years; range = 15.7-67.8 years). The most common diagnoses for the OCA transplantation were osteochondritis dissecans (44.3%) and avascular necrosis (31.1%). Pain and function improved preoperatively to postoperatively on all outcome scales (P < 0.01). The majority of patients (86%) were "extremely satisfied" or "satisfied." OCA survivorship was 89.5% at 5 years and 74.7% at 10 years. At latest follow-up (mean = 7.6 years; range = 1.9-22.6 years), OCA remained in situ in 50 knees (82%). Eighteen knees (29.5%) had further surgery; 11 OCA failures and 7 other surgical procedure(s). Of the failed knees (mean time to failure = 3.5 years; range = 0.5-13.7 years), 8 were converted to arthroplasty, 2 had OCA revisions, and 1 had a patellectomy.
  
  
  CONCLUSIONS
  OCA transplantation is an acceptable primary treatment method for some chondral and osteochondral defects of the knee. Failure of previous treatment(s) is not a prerequisite for OCA transplantation.
authors.affiliation: Department of Orthopaedics, University of New Mexico, Albuquerque, NM, USA.
authors.forename: Dustin T
authors.initials: DT
authors.lastname: Briggs
authors.affiliation: Kaiser Permanente, Freemont, CA, USA.
authors.forename: Kamran N
authors.initials: KN
authors.lastname: Sadr
authors.affiliation: Shiley Center for Orthopaedic Research & Education at Scripps Clinic, La Jolla, CA, USA.
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Pulido
authors.affiliation: Shiley Center for Orthopaedic Research & Education at Scripps Clinic, La Jolla, CA, USA ; Division of Orthopaedics, Scripps Clinic, La Jolla, CA, USA.
authors.forename: William D
authors.initials: WD
authors.lastname: Bugbee
keywords: cartilage repair; knee; osteochondral allograft transplantation