FRESH OSTEOCHONDRAL ALLOGRAFTS FOR POSTTRAUMATIC OSTEOCHONDRAL DEFECTS OF THE KNEE

We used fresh small-fragment osteochondral allografts to reconstruct p ost-traumatic osteochondral defects in 126 knees of 123 patients with a mean age of 35 years. At a mean follow-up of 7.5 years (2 to 20), 10 8 knees were rated as successful (85%) and 18 had failed (15%). The fa ctors related to failure included age over 50 years (p = 0.008), bipol ar defects (p < 0.05), malaligned knees with overstressing of the graf ts, and workers' compensation cases (p < 0.04). Collapse of the graft by more than 3 mm and of the joint space of more than 50% were seen mo re frequently in radiographs of failed grafts. Our encouraging clinica l results for fresh small-fragment osteochondral allografts show that they are indicated for unipolar post-traumatic osteochondral defects o f the knee in young active patients.