Long-term followup of the use of fresh osteochondral allografts for posttraumatic knee defects

Posttraumatic osteochondral defects of the distal femur or proximal tibia pose a reconstructive challenge for the young active patient. Fresh osteochondral allografts have been used to reconstruct these defects and this report deals with the long-term clinical and radiographic follow-up in this patient population. This is a prospective nonrandomized study. Sixty patients with an average followup of 10 years received femoral condylar grafts. Twelve grafts failed, requiring removing of the graft in three patients and conversion to total knee replacement in nine patients. Kaplan-Meier survivorship showed 95% graft survival at 5 years and 85% at 10 years. Sixty-five patients received fresh osteochondral allografts to reconstruct the tibial plateau with an average followup of 11.8 years. In this group of patients, conversion to total knee arthroplasty was done in 21 patients at a mean interval of 9.7 years. Survival analysis revealed 95% survival at 5 years, 80% at 10 years, and 65% at 15 years. Through our long-term prospective study, we confirm the value of fresh osteochondral allografts to reconstruct articular defects of the knee in the young active patient. Level of Evidence: Therapeutic study, Level II-1 (prospective cohort study). See the Guidelines for Authors for a complete description of levels of evidence.