Limited data exists defining preoperative variables that affect outcomes after osteochondral allograft transplantation (OAT) in the knee. In this retrospective study, we examined 75 patients who underwent OAT for large (≥2 cm) grade IV cartilage defects in the femoral condyle. Patient variables evaluated included the following: smoking, workers compensation, body mass index (BMI), pre-injury activity level, number, and the type of co-morbidities in the operated knee, lesion location and number of grafts placed. OCA donor age and graft storage duration from procurement were also evaluated. Preoperative and postoperative visual analogue scale (VAS) pain scores were the primary outcome measure. Overall, 53 patients (71%) had successful outcomes, with 81% of patients without co-morbidities having successful outcomes. Active patients were significantly ( = 0.023) more likely to have a successful outcome than low activity patients. Patients with BMI <35 were 4 times more likely to have a successful outcome ( = 0.01). There were no significant differences based on donor age. Patients with transplanted grafts stored >28 days were significantly ( = 0.048) and 2.6 times more likely to have an unsuccessful outcome. This study provides new evidence for preoperative patient factors and graft variables that may influence the overall outcome after osteochondral transplantation in the knee.

Background: This study aimed to investigate if nonsteroidal anti-inflammatory drugs (NSAIDs) used in the acute phase of bone healing in children with fractures result in delayed union or nonunion as compared with patients who do not take NSAIDs for pain control during this same time period. Methods: In this prospective, randomized, parallel, single-blinded study, skeletally immature patients with long bone fractures were randomized to 1 of 2 groups for their postfracture pain management. The NSAID group was prescribed weight-based ibuprofen, whereas the control group was not allowed any NSAID medication and instead prescribed weight-based acetaminophen. Both groups were allowed to use oxycodone for breakthrough pain. The primary outcome was fracture healing assessed at 2, 6, and 10 weeks. Results: One-hundred-two patients were enrolled between February 6, 2014 and September 23, 2016. Ninety-five patients (with 97 fractures) completed a 6-month follow-up (46 patients with 47 fractures in the control group and 49 patients 50 fractures in the NSAID group). None achieved healing at 1 to 2 weeks. By 6 weeks, 37 of 45 patients (82%) of control group and 46 out of 50 patients (92%) of ibuprofen group had healed fractures (P=0.22). At 10 to 12 week follow-up, 46 (98%) of the control group fractures were healed and 50 (100%) of the ibuprofen group fractures were healed. All were healed by 6 months. Healing was documented at a mean of 40 days in the control group and 31 days in the ibuprofen group (P=0.76). The mean number of days breakthrough oxycodone was used was 2.4 days in the control group and 1.9 days in the NSAID group (P=0.48). Conclusion: Ibuprofen is an effective medication for fracture pain in children and its use does not impair clinical or radiographic long bone fracture healing in skeletally immature patients. Level of Evidence: Level I—therapeutic.