DOI: 10.1177/23259671261457786 ISSN: 2325-9671

Association of Donor Characteristics and Graft Storage Time with Survivorship of Osteochondral Allograft Transplantation in the Knee

Suzanne M. Tabbaa, Julie C. McCauley, Dennis C. Crawford, William D. Bugbee
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Background:

The effect of donor tissue characteristics on osteochondral allograft (OCA) efficacy for treating chondral and osteochondral lesions of the knee is poorly understood. Studies on graft storage time show inconsistent effects on clinical outcomes, and research on donor-specific factors remains limited.

Purpose:

To (1) assess the association between donor characteristics and graft storage time with allograft recipient survivorship; and (2) determine whether patient-reported outcomes and satisfaction differed across donor characteristics.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A total of 220 patients (236 knees) who underwent primary fresh OCA transplantation of the knee with a minimum 2-year follow-up were included in this study. Patients with degenerative indications were excluded. Failure (defined as further procedure such as removal or revision) and survivorship rates were compared between patients receiving OCA grafts from donors aged ≤20 or >20 years, with a body mass index (BMI) ≤30 or >30 kg/m 2 , of the same sex (sex-matched) or different sex (sex-mismatched), released early (1-14 days) or late (15-28 days). International Knee Documentation Committee (IKDC) scores and satisfaction were compared between groups.

Results:

The mean follow-up was 8.2 years. Grafts from older donors (>20 years) had a significantly higher failure rate than grafts from younger donors (11.7% vs 3.7%; P = .039). Ten-year survival was 89.3% in the older donor group and 100% in the younger donor group. OCA failure rate for early-release grafts (22.7%) was significantly higher than late-release grafts (6%) ( P = .002). Survivorship was 85.6% at 10 years for early-release grafts and 96.1% for late-release grafts. Grafts from older donors were 6.96 times more likely to fail than grafts from younger donors ( P = .039), and early-release grafts were 6.90 times more likely to fail than late-release grafts ( P = .002). Donor BMI and sex matching did not impact failure rate or survivorship. IKDC scores and satisfaction did not differ statistically between donor characteristic groups.

Conclusion:

These findings suggest that donor age should be considered for OCA transplantation and that shorter graft storage times, donor BMI, and sex matching may not be required for successful clinical outcomes.

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