Clinical Characteristics Analysis Of Osteochondral Allograft Transplantation For Treating Articular Cartilage Defects From 2001 To 2020

Objective:Osteochondral allograft transplantation treats symptomatic focal cartilage defects with satisfactory clinical results.To comprehensively analyze osteochondral allograft transplantation’s characteristics and clinical outcomes in treating articular cartilage defects.Methods:We searched Embase,Pub Med,Cochrane Database,and Web of Science for all relevant articles on osteochondral allograft transplantation treating articular cartilage defects from 2001 to 2020.Studies were screened and selected using inclusion and exclusion criteria.Publication year,country,first author,patient number,demographic data,osteochondral allograft storage details,and clinical outcomes were extracted to conduct a comprehensive summative analysis.Results:In total,105 studies involving 5952 patients were included.The annual number of patients treated with osteochondral allograft transplantation increased from 69 in 2001 to1065 in 2020,peaking at 1504 cases in 2018.Most studies(90.12%)were performed in the United States.The average age at surgery was 34.16 years,and 60.8%of patients were male.The patients’mean body mass index was 26.74.The mean lesion area was5.05 cm~2,mean follow-up duration was 54.39 months,average graft size was 6.85 cm~2,and the number of grafts per patient was 1.49.After osteochondral allograft transplantation,18.8%of patients failed,and 83.1%reported satisfactory results.The analysis demonstrated allograft survival rates at 2,5,10,15,20,and 25 years of 94%,87.9%,80%,73%,55%,and 59.4%,respectively.Osteochondral allograft transplantation was mainly performed on the knee(88.88%).The most common diagnosis in the knee was osteochondritis dissecans(37.9%),and the most common defect location was the medial femoral condyle(52%).The most common concomitant procedures were high tibial osteotomy(28.4%)and meniscal allograft transplantation(24.7%).After osteochondral allograft transplantation failures,54.4%of patients underwent revision with primary total knee arthroplasty.Conclusion:The annual number of patients showed a significant upward trend,especially from2016 to 2020.Patients receiving osteochondral allograft transplantation were predominantly high BMI young adults.Osteochondral allograft transplantation is more established for knee cartilage than an injury at other sites,and its best indication is osteochondritis dissecans.This analysis demonstrated satisfactory long-term postoperative outcomes.