Today's News

Thursday, February 13, 1997

Osteochondral allografts useful for resurfacing knee defects of young patients

The use of fresh osteochondral shell allografts for resurfacing of osteochondral defects in the knee has been shown to be a useful treatment for patients who are too young and too active for total knee replacement.

Between December 1983 and April 1991, 49 knees were resurfaced using fresh osteochondral shell allografts; 46 knees were followed for an average of 78 months. Thirty-six knees were monopolar replacements and 10 were reciprocal bipolar resurfacing. The mean age of the patients was 36.2 years (range: 16 to 67 years).

The damaged articular surface with approximately 5 millimeters of subchondral bone was removed and a similarly-sized and located allograft was harvested from a size-matched donor between 16 and 45 years old, said Constance R. Chu, MD, resident in orthopaedics, University of California, San Diego. Dr. Chu, co-author of the study presented in scientific exhibit S 12, said the results were rated "excellent" if the knee was pain-free, has a full range of motion and permitted unlimited activity. A "good" knee allowed full employment and gave only occasional trouble with vigorous athletics. Overall, 35 of 46 knees were rated good to excellent, or a success rate of 74 percent, Dr. Chu said.

Many patients returned to unlimited vigorous athletics such as snow and waterskiing, surfing, basketball and singles tennis.

Seventy-eight percent of the knees in the monopolar group and 60 percent in the bipolar group were rated good to excellent. Seventy-three percent resurfaced more than 10 years ago, with 75 to 144 months of follow-up, achieved a good to excellent rating.

Co-authors of the study, all of the University of California, San Diego, are F. Richard Convery, MD, professor of orthopaedics; Wayne H. Akeson, MD, professor of orthopaedics; and Marvin Meyers, MD, emeritus professor of orthopaedics.