Long-Term Follow-up of Fresh Tibial Osteochondral Allografts for Failed Tibial Plateau Fractures

• Published in: Journal of bone and joint surgery. American volume 2003-04, Vol.85 (suppl_2 Suppl 2), p.33-39
• Main Authors: Shasha, Nadav, Krywulak, Steve, Backstein, David, Pressman, Ari, Gross, Allan E
• Format: Article
• Language: English
• ISSN: 0021-9355; 1535-1386

BackgroundThe management of large posttraumatic full-thickness osteochondral defects in the proximal part of the tibia remains a challenge. The goal of treatment is a pain-free range of motion of the knee that provides enduring function and enables a young patient to participate in a wide range of activities. The use of fresh osteochondral allograft transplantation for tibial plateau lesions has been well documented. The purpose of the present study was to assess the survivorship and the long-term functional outcome following fresh osteochondral transplantation for unipolar posttraumatic tibial plateau defects in young, high-demand patients.MethodsA cohort study was carried out to assess outcome in patients who had undergone fresh tibial osteochondral grafting for the treatment of a posttraumatic defect that measured at least 3 cm in diameter and 1 cm in depth. Sixty-five (97%) of sixty-seven patients were identified and were evaluated clinically and radiographically. A modified Hospital for Special Surgery (HSS) score was calculated for each patient. Radiographic examination was directed toward the identification of graft union, resorption, or collapse. Degeneration of the joint and alignment of the limb (on standing radiographs) was assessed. The end points that defined survivorship were an HSS score of