Clinical Outcomes of Unipolar Versus Bipolar Patellofemoral Fresh Osteochondral Allograft Transplantation.
Background: Osteochondral allograft (OCA) transplantation in the tibiofemoral joint has been extensively studied, but limited data exist regarding outcomes after patellofemoral (PF) OCA transplantation, particularly for bipolar osteochondral lesions. Purpose: To compare graft failure rates, graft re...
| Publicado en: | American Journal of Sports Medicine Vol. 54; no. 5; pp. 1045 - 1055 |
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| Autores principales: | , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
Apr2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=192584431&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 192584431 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03635465 ASM jtl: American Journal of Sports Medicine issn: 03635465 maglogo: Y pubinfo: dt: Apr2026 vid: 54 iid: 5 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 192584431 192584431 192679427 192584431 10.1177/03635465261426568 192584431 ppf: 1045 ppct: 10 formats: tig: atl: Clinical Outcomes of Unipolar Versus Bipolar Patellofemoral Fresh Osteochondral Allograft Transplantation. aug: au: Acheampong, Kofi K. Augustin, Edouard J. Moran, Thomas E. Atkins, Myles Akinleye, John Bi, Andrew S. Cole, Brian J. Yanke, Adam B. affil: Rush University Medical Center, Chicago, Illinois, USA sug: subj: Bone Transplantation Allografts Knee Joint Surgery Cartilage Diseases Surgery Graft Rejection Evaluation Reoperation Evaluation Patient-Reported Outcomes Evaluation Treatment Outcomes Evaluation Illinois Human Male Female Adult Descriptive Statistics Retrospective Design Record Review Prospective Studies Pretest-Posttest Control Group Design Multiple Logistic Regression Odds Ratio Confidence Intervals Funding Source Fisher's Exact Test Wilcoxon Rank Sum Test Unpaired T-Tests Wilcoxon Signed Rank Test Paired T-Tests Logistic Regression Kaplan-Meier Estimator Log-Rank Test Univariate Statistics Adult: 19-44 years Male Female ab: Background: Osteochondral allograft (OCA) transplantation in the tibiofemoral joint has been extensively studied, but limited data exist regarding outcomes after patellofemoral (PF) OCA transplantation, particularly for bipolar osteochondral lesions. Purpose: To compare graft failure rates, graft reoperation rates, and patient-reported outcomes (PROs) between patients who underwent unipolar and bipolar PF OCA transplantation at the ≥2-year follow-up. Study Design: Cohort study; Level of evidence, 4. Methods: A retrospective review of a prospectively maintained institutional database identified patients who underwent PF OCA transplantations from 2015 to 2024. Patients with concomitant tibiofemoral OCA transplantation or <2 years of follow-up were excluded. Outcomes including graft failure, reoperation, and PROs were compared between patients in the unipolar and bipolar groups who underwent PF OCA transplantation. Preoperative, surgical, and postoperative variables were assessed for associations with outcomes using multivariable regression analysis. Results: A total of 36 knees (24 unipolar, 12 bipolar) from 35 of 41 (85.4%) eligible patients (68.6% female; mean age, 33.59 ± 8.10 years; mean body mass index, 29.24 ± 5.28 kg/m2) were included. The mean follow-up was 3.58 ± 1.39 years (3.87 ± 1.45 years for unipolar vs 3.00 ± 1.10 for bipolar; P =.046). Groups did not differ in baseline PROs, prior surgeries (P =.53) or cartilage repair (P =.66), and concomitant (P =.19) or prior (P =.48) tubercle osteotomy. Structural graft failure was higher in bipolar lesion knees (3 [25%] bipolar vs 0 [0%] unipolar; P =.03) but notably associated with cumulative lesion area (OR, 1.005; 95% CI, 1.0004-1.0114; P =.031). Among patients without failure, both groups demonstrated significant and similar improvements in International Knee Documentation Committee (IKDC) and Knee injury and Osteoarthritis Outcome Score (KOOS) subscores at the final follow-up (all P ≤.036), with no between-group difference in achievement of IKDC, KOOS Pain, KOOS Symptoms, and KOOS Sports clinically significant outcomes. Graft reoperation rates were similar (3 [12.5%] unipolar vs 1 [8.33%] bipolar; P >.99). Conclusion: Bipolar and unipolar PF OCA transplantation both yielded excellent and comparable short- to midterm postoperative PROs, clinically significant functional improvement, and reoperation rates. Although larger cumulative bipolar lesions may indicate a higher disease burden and risk of graft failure, bipolar transplantation remained effective and clinically beneficial in most patients at the final follow-up, delaying arthroplasty and associated increased complication rates in this young patient cohort. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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