Short-Term Patient-Reported Outcomes After Osteochondral Allograft Combined With Concomitant Knee Procedures Predict Mid- and Long-Term Outcomes.

Abstract

To determine whether short-term patient-reported outcomes (PROs) after primary osteochondral allograft (OCA) of the knee correlate with mid- and long-term PROs at a minimum 5-year follow-up. A retrospective review of a prospectively maintained database of patients who underwent single or multifocal plug OCA in 2001-2019 was performed. Inclusion criteria included patients with preoperative, 2-year, and minimum 5-year postoperative PROs. Exclusion criteria included cases of revision OCA and a pre-existing diagnosis of inflammatory arthritis. PROs assessed included International Knee Documentation Committee (IKDC) score, all subscales of the Knee Injury and Osteoarthritis Outcome Score (KOOS), and Lysholm score. Mid-term PROs were defined as 5-10 years, and long-term PROs as ≥10 years. A total of 77 patients (mean age 31.1 ± 9.2 years, 55.8% female) met inclusion criteria. Mean follow-up was 8.9 ± 3.4 years (range, 4.8-17.2). Sixty-six (85.7%) patients underwent a concomitant procedure. Two-year PROs significantly correlated with midterm (5-10 years) improvements: IKDC (P = .0050), KOOS Pain (P = .0132), KOOS Symptoms (P = .0001), KOOS ADL (P = .0058), KOOS Sport (P = .0037), KOOS QOL (P = .0024), and Lysholm (P = .0233). In addition, 2-year PROs were significantly correlated with long-term (≥10 years) improvements: IKDC (P ≤ .0001), KOOS Pain (P = .0046), KOOS Symptoms P = .0025), KOOS ADL (P ≤ . 0001), KOOS Sport (P = .0052), KOOS QOL P = .0039), and Lysholm (P = .0145). MCID achievement ranged from 57.4% to 85.9% at short-term follow-up, 42.9% to 77.4% at midterm follow-up, and 45.0% to 89.5% at long-term follow-up. In total, 13 patients (16.8%) had any subsequent reoperation on the same knee, none of which included revision OCA or arthroplasty. Two-year improvements in PROs following primary OCA are predictive of sustained mid- and long-term improvements, with significant correlations between 2-year outcomes and those at 5-10 years and ≥10 years. Level IV, retrospective case series.