title: Osteochondral Allograft Transplantation of the Femoral Trochlea.
abstract: BACKGROUND
  Osteochondral allograft (OCA) transplantation is a recognized treatment modality for cartilage damage in the knee. Few reports are available on outcomes of OCA in the patellofemoral joint, and there are no reports on lesions isolated to the femoral trochlea.
  
  
  OBJECTIVE
  To evaluate graft survivorship and clinical outcomes in patients who had an OCA to the femoral trochlea.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  An OCA database was used to identify 29 knees in 28 patients (mean age, 30.2 years; range, 12-47 years; 8 female, 20 male) who were treated with a fresh OCA transplant limited to the femoral trochlea. The primary outcome was graft survivorship, and the minimum follow-up was 2 years. Clinical outcomes were assessed by the modified Merle d'Aubigné-Postel (18-point) score; Knee Society function (KS-F) score; International Knee Documentation Committee (IKDC) pain, function, and total scores; and University of California, Los Angeles (UCLA) activity score. The OCA patient satisfaction score (5-point scale from extremely satisfied to dissatisfied) was also reported.
  
  
  RESULTS
  The mean follow-up period was 7.0 years (range, 2.1-19.9 years). Graft survivorship was 100% at 5 years and 91.7% at 10 years. One patient was converted to a total knee arthroplasty 7.6 years after OCA surgery. The mean modified Merle d'Aubigné-Postel score improved from 13.0 to 16.1, the mean KS-F score from 65.6 to 85.2, and the mean IKDC total score from 38.5 to 71.9; the mean UCLA score was 7.9 postoperatively. Eighty-nine percent of patients were extremely satisfied or satisfied with the outcome of surgery.
  
  
  CONCLUSIONS
  Fresh OCA transplantation resulted in excellent clinical outcomes in this patient cohort with articular cartilage damage to the femoral trochlea. The procedure resulted in improved pain and function and high patient satisfaction.
authors.affiliation: Greenville Health System, Steadman Hawkins Clinic of the Carolinas, Greenville, South Carolina, USA.
authors.forename: James I
authors.initials: JI
authors.lastname: Cameron
authors.affiliation: Shiley Center for Orthopaedic Research and Education at Scripps Clinic, La Jolla, California, USA.
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Pulido
authors.affiliation: Shiley Center for Orthopaedic Research and Education at Scripps Clinic, La Jolla, California, USA.
authors.forename: Julie C
authors.initials: JC
authors.lastname: McCauley
authors.affiliation: Division of Orthopaedic Surgery, Scripps Clinic, La Jolla, California, USA Bugbee.william@scrippshealth.org.
authors.forename: William D
authors.initials: WD
authors.lastname: Bugbee
mesh_terms: D000293:Adolescent; D000328:Adult; D064591:Allografts / Q000502:physiology; D019645:Arthroplasty, Replacement, Knee / Q000379:methods; D001265:Athletic Injuries / Q000601:surgery; D016025:Bone Transplantation / Q000379:methods*; D002358:Cartilage, Articular / Q000293:injuries* / Q000601:surgery; D002648:Child; D019902:Chondrocytes / Q000637:transplantation*; D005260:Female; D005269:Femur / Q000601:surgery*; D005500:Follow-Up Studies; D006085:Graft Survival / Q000502:physiology; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D057071:Patellofemoral Joint / Q000601:surgery; D017060:Patient Satisfaction; D012086:Reoperation; D000068958:Return to Sport; D014184:Transplantation, Homologous / Q000379:methods; D055815:Young Adult
keywords: articular cartilage; knee; osteochondral allograft; trochlea