Lesion Size Does Not Predict Outcomes in Fresh Osteochondral Allograft Transplantation

Purpose: Many cartilage repair algorithms use lesion size to choose the appropriate surgical technique. The purpose of this study was to determine if lesion size affects outcomes after an osteochondral allograft (OCA) transplantation.  


  • 156 knees from 143 patients who had an OCA transplantation for an isolated femoral condyle lesion were included.
  • The total area of the allograft (obtained by squaring the diameter) was used to determine the absolute size of the lesion. Lesions were categorized as either small (<5cm2), medium (5-8 cm2) and large (>8cm2).
  • Despite variability in preoperative IKDC scores across the three groups, the postoperative outcome scores were similar in all groups. The greatest clinical improvement was seen in patients with the largest grafts.
  • Overall survivorship of the OCA was 97.2% at 5 years and 93.5% at 10 years.
  • Additional surgery was performed in 38 knees only 9 of which were due to graft failure (5.8%).

JRF Ortho Take Away:  The results of this study suggest that graft size does not influence outcomes or survivorship. OCA transplantation is an effective treatment in the femoral condyle regardless of size.

Click here to read the abstract or entire article. Also, please see the poster from AAOS (link below).

Authors: Luis E.P. Turico, Julie C. McCauley, Pamela A. Pulido, William D. Bugbee

Published: The American Journal of Sports Medicine, March 2018.

Institution: Scripps Clinic

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