Effectiveness and safety of osteochondral allograft transplantation in the knee joint: A meta-analysis / 中国组织工程研究

ABSTRACT

BACKGROUND: Osteochondral allograft transplantation for the treatment of knee articular cartilage defects is one of the longest clinical methods. Although this method is widely used in clinical practice and is trusted by orthopedic surgeons, it still lacks evidence-based medicine support. OBJECTIVE: To investigate the efficacy of osteochondral allograft transplantation in the knee joint, systematic review and meta-analysis of all available data, and evaluate the efficacy and safety of osteochondral allograft as a transplant substitute in knee joint surgery. METHODS: Literature search was conducted in PubMed/Medline, EMBASE, Cochrane Collaboration Library, China National Knowledge Infrastructure and Wanfang Database. The application of osteochondral allograft in knee joint transplantation was searched and selected according to the literature inclusion criteria. Articles whose data can be extracted and meta-analyzable were mainly selected. RESULTS AND CONCLUSION: (1) Twenty-five studies met the inclusion criteria and were all case series studies. The patient reported that osteochondral allograft can be used as a graft material to repair knee joint defects. A total of 1 081 patients (1 111 knees) were included in the study. The age of onset was 11-75 years old, with an average age of 34.41 years. The proportion of women was about 40.81%. The follow-up period was 4-384 months, with an average of 76.8 months. (2) In these studies, donors received a minimum age of 10 years and a maximum of 65 years. According to the donor age range and number of studies, donors aged 15-45 were the primary targets. (3) The overall success rate after surgery was 74%, and the overall secondary operation rate was 17%. The success rate of unipolar surgery was 74.44% (501/673); the success rate of bipolar surgery was 50.94% (27/53). The success rate of unipolar surgery was significantly higher than that of bipolar surgery (χ2 =13.679, P < 0.05). (4) Treatment complications occurred in 67 patients (13.14%, 67/510). Common complications were persistent pain at the surgical site (15 cases), graft fracture or fragmentation (12 cases). (5) These results indicate that osteochondral allograft is an effective and safe substitute for knee joint transplantation. The overall success rate is 74% and the secondary operation rate is 17%. It is a treatment with high success rate and low risk of reoperation.