Metrics of OsteoChondral Allografts (MOCA) Group Consensus Statements on the Use of Viable Osteochondral Allograft

Purpose: To develop consensus among an expert group with extensive clinical and scientific experience in osteochondral allografts (OCAs), addressing controversies in treatment of cartilage and subchondral defects with OCA transplantation.


  • The MOCA group participated in a 3-round modified Delphi process on topics that lead to debate and lack scientific evidence in the areas of surgical technique, graft matching, indications, and rehabilitation/return to sport.
    • Group members were selected for their contributions to the science and clinical application of OCAs and consists of the most highly experienced surgeons.
  • A systematic literature review was conducted to assess the level of agreement each statement had with established research.
    • Topics such as the management of cysts and unstable grafts achieved unanimous agreement despite limited evidence in the literature.
  • Further areas of study were proposed such as efficacy of pulse lavage, the use of biologic adjuncts and a standardized method for testing cellular viability.
  • After final voting, 17 statements reached consensus.
    • 11 received unanimous agreement (100%) and 6 received strong agreement (80-99%)

Take-Away: The 17 statements generated over three rounds of the Delphi process help provide guidance on surgical and perioperative management of lesions with OCA transplantation.

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Authors: Simon Gortz, MD, Suzanne M. Tabbaa, PhD, Deryk G. Jones, MD, John D. Polousky, MD, Dennis C. Crawford, MD, PhD and the MOCA Committee

Published: The Orthopaedic Journal of Sports Medicine, March 2021.

Institution: Final round of voting took place at the Orthopaedic Learning Center in Rosemont, IL

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