Donor-recipient age- or sex-mismatched osteochondral allografts do not adversely affect cumulative graft survival rates after transplantation in the knee

IF 1.6 4区医学 Q3 ORTHOPEDICS Knee Pub Date : 2024-09-05 DOI:10.1016/j.knee.2024.08.008

Jonathan Williams , Kylee Rucinski , James P. Stannard , Josh Pridemore , Aaron M. Stoker , Cory Crecelius , Clayton W. Nuelle , James L. Cook

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Abstract

Background

Osteochondral allograft transplantation (OCAT) can be performed without the need for blood-type matching or anti-rejection medications. However, other donor-recipient mismatch variables could influence outcomes. Therefore, it is critical to examine the impacts of sex and age mismatching on functional OCA survival.

Methods

Prospectively collected data for patients undergoing primary knee OCAT enrolled in a lifelong outcomes registry were analyzed for functional OCA survival based on sex- and age-matched and −mismatched cohorts. Treatment failure was defined as the need for OCAT revision surgery or knee arthroplasty.

Results

162 donor-recipient pairs were analyzed; 57 (35.2%) were sex-mismatched and 89 (54.9%) were age-mismatched. Sex-mismatched OCATs were not associated with a significantly different cumulative graft survival rate when compared to sex-matched OCATs (78.9% vs 75.2% p = 0.324). Age-mismatched OCATs were not associated with a significantly different cumulative graft survival rate when compared to age-matched OCATs (71.6% vs 81.5% p = 0.398). When adjusting for sex, BMI, concomitant procedures, and surgery type, age-mismatched and sex-mismatched OCATs were not significantly associated with higher likelihood for treatment failure.

Conclusion

By analyzing functional graft survival rates for donor-recipient sex- or age-mismatched OCAs following primary OCAT, the results of the present study support current donor-recipient matching protocols for OCA transplantation in the knee. Based on current evidence, donor-recipient blood-type, sex-, and age-matching are not required for safe and effective primary OCAT in the knee. However, further studies are imperative for defining modifiable variables that further optimize safety and outcomes while maximizing donor tissue quality, availability, access, and use.

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供体与受体年龄或性别不匹配的骨软骨异体移植物不会对膝关节移植后的累积移植物存活率产生不利影响

背景骨软骨异体移植（OCAT）无需血型匹配或抗排斥药物即可进行。然而，其他供体-受体不匹配变量可能会影响移植结果。因此，研究性别和年龄不匹配对功能性OCA存活率的影响至关重要。方法根据性别和年龄匹配及不匹配队列，分析了终生结果登记处前瞻性收集的接受初级膝关节OCAT患者的数据，以分析功能性OCA存活率。结果分析了162对供体和受体，其中57对（35.2%）性别不匹配，89对（54.9%）年龄不匹配。与性别不匹配的 OCAT 相比，性别不匹配的 OCAT 的累积移植物存活率没有明显差异（78.9% vs 75.2% p = 0.324）。与年龄匹配的 OCAT 相比，年龄不匹配的 OCAT 与累积移植物存活率无明显差异（71.6% vs 81.5% p = 0.398）。结论通过分析初级 OCAT 后供体-受体性别或年龄不匹配的 OCA 的功能性移植物存活率，本研究结果支持目前膝关节 OCA 移植的供体-受体匹配方案。根据目前的证据，供体与受体的血型、性别和年龄不匹配并不是安全有效的膝关节原发性 OCAT 的必要条件。然而，进一步的研究势在必行，以确定可修改的变量，从而进一步优化安全性和疗效，同时最大限度地提高供体组织的质量、可用性、可及性和使用率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee 医学-外科

CiteScore

3.80

自引率

5.30%

发文量

171

审稿时长

6 months

期刊介绍： The Knee is an international journal publishing studies on the clinical treatment and fundamental biomechanical characteristics of this joint. The aim of the journal is to provide a vehicle relevant to surgeons, biomedical engineers, imaging specialists, materials scientists, rehabilitation personnel and all those with an interest in the knee. The topics covered include, but are not limited to: • Anatomy, physiology, morphology and biochemistry; • Biomechanical studies; • Advances in the development of prosthetic, orthotic and augmentation devices; • Imaging and diagnostic techniques; • Pathology; • Trauma; • Surgery; • Rehabilitation.