Bipolar Osteochondral Allograft Transplantation of the Patella and Trochlea

Purpose: To evaluate the outcomes of bipolar osteochondral allograft (OCA) transplantation in the patellofemoral joint.

Summary:

  • Limited studies are available pertaining to OCA transplantation in the patellofemoral joint, especially on bipolar OCAs to both the patella and trochlea
  • Follow-up was obtained on 15 knees that underwent a combined OCA transplant to address either trochlear dysplasia with patellofemoral instability or high grade chondral lesions
  • OCA plugs were harvested from patella and trochlear grafts from the same donor to provide a congruent anatomic surface
  • At an average follow-up of 33.2 months, significant functional improvements were observed in KOOS, IKDC, Tegner, Oxford, Cincinnati, VAS and SANE scores
  • While two patients did require further surgery to address postoperative stiffness and lysis of adhesions, no patient needed revision or conversion to arthroplasty and there were no patellar re-dislocations

JRF Ortho Take Away: While previous studies have shown that OCA transplantation to the patellofemoral joint can have an increased risk of failure compared to other areas of the knee, bipolar OCA transplantation to the patella and trochlea using tissue from the same donor can be a good option. At short to mid-term follow-up, this technique demonstrated significant improvement for recurrent dislocation and high grade chondral lesions.

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