Long-Term Outcomes of Osteochondral Allograft with Osteogenic Protein-1 Augmentation: A Twelve-Year Follow-Up.

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Abstract

Conflict of interest statement: The authors have no financial or proprietary interest in the subject matter of this article. 17. Knee Surg Sports Traumatol Arthrosc. 2019 Sep;27(9):3001-3013. doi: 10.1007/s00167-018-5321-8. Epub 2018 Dec 12. Cartilage repair surgery prevents progression of knee degeneration. Jungmann PM(1)(2), Gersing AS(3), Baumann F(4), Holwein C(5)(6), Braun S(5)(7), Neumann J(8), Zarnowski J(8), Hofmann FC(8), Imhoff AB(5), Rummeny EJ(3), Link TM(8). Author information: (1)Department of Neuroradiology, University Hospital of Zurich, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland. pia.jungmann@usz.ch. (2)Department of Radiology, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany. pia.jungmann@usz.ch. (3)Department of Radiology, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany. (4)Clinical and Interventional Angiology, University Hospital of Zurich, University of Zurich, Raemistrasse 100, 8091, Zurich, Switzerland. (5)Department of Sportsorthopedic Surgery, Technical University of Munich, Ismaninger Strasse 22, 81675, Munich, Germany. (6)BG Unfallklinik Murnau, Prof.-Küntscher-Strasse 8, 82418, Murnau, Germany. (7)Gelenkpunkt, Sports and Joint Surgery Innsbruck, Olympiastrasse 39, 6020, Innsbruck, Austria. (8)Musculoskeletal and Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California, San Francisco, 185 Berry Street, Suite 350, San Francisco, CA, 94107, USA. PURPOSE: To investigate, whether cartilage repair surgery for focal osteochondral defects at the knee results in less degenerative changes over 6 years in a MR imaging follow-up than morphologically initially identical defects in non-operated control subjects from the osteoarthritis initiative (OAI). METHODS: A total of 32 individuals received baseline and follow-up MRI. In n = 16 patients with cartilage repair [osteochondral autograft transfer system (OATS), n = 12; spongiosa-augmented matrix-associated autologous chondrocyte implantation (MACI), n = 4] MRI was performed preoperatively and after 5.7 ± 2.3 year follow-up. Baseline MRIs of non-operated subjects from the OAI were screened for initially identical cartilage defects (n = 16). Morphological knee abnormalities were assessed using WORMS, AMADEUS and MOCART scores. A sagittal 2D MSME sequence was implemented for quantitative cartilage T2 relaxation time measurements in all (0, 2, 4, 6 and 8-years) follow-ups from the OAI and in the postoperative MRI protocol. RESULTS: For both groups, focal osteochondral defects were located at the femoral condyle in 8/16 cases (5 medial, 3 lateral) and at the patella in 8/16 cases. At baseline, the mean cartilage defect size ± SD was 1.4 ± 1.3 cm2 for the control group and 1.3 ± 1.2 cm2 for the cartilage repair group (n.s.). WORMS scores were not significantly different between the cartilage repair group and the control group at baseline [mean difference ± SEM (95%CI); 0.5 ± 2.5 (- 4.7, 5.7), n.s.]. During identical follow-up times, the progression of total WORMS scores [19.9 ± 2.3 (15.0, 24.9), P