Fresh Osteochondral Allografts in the Knee: Comparison Transplantations

Purpose:  Previous studies have shown that ACI treatment following a Subchondral Marrow Stimulation (SMS) procedure caused a failure rate three to five times higher than performing a primary ACI procedure. This study sought to determine the effects of performing an OCA transplantation after SMS procedures versus as a primary procedure.


  • SMS techniques include microfracture, drilling, and abrasion arthroplasty. These are considered first line treatments for cartilage lesions.
  • The study consisted of two groups: the first (Group 1) had 46 knees where OCA transplantation was the primary treatment method, the second (Group 2) had 46 knees that had an OCA transplantation after a failed SMS procedure.
  • Both groups showed improvement in pain and function on all subjective scores from pre-op to their latest follow-up.
  • Group 1 had five failures (11%) whereas Group 2 had seven failures (15%). The failure rate was not statistically significant between groups.
  • At 10 years follow-up, survivorship was 87.4% and 86% for Groups 1 and 2, respectively.

Take Away: Contrary to results demonstrated with ACI, the treatments performed in both groups provided reliable and effective options. In both there was improvement in pain and function and long-term survivorship with insignificant statistical differences between groups.

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Gracitelli, G. C., G. Meric, D. T. Briggs, P. A. Pulido, J. C. Mccauley, J. C. Belloti, and W. D. Bugbee. "Fresh Osteochondral Allografts in the Knee: Comparison of Primary Transplantation Versus Transplantation After Failure of Previous Subchondral Marrow Stimulation." The American Journal of Sports Medicine 43.4 (2015): 885-91. Web.