Return to Play Among Elite Basketball Players After Osteochondral Allograft Transplantation of Full-Thickness Cartilage Lesions

Abstract

Background:Osteochondral allograft transplantation (OCA) is a recognized option for full-thickness articular cartilage defects of the knee, especially in the setting of large lesions or those involving the subchondral bone. Previous heterogenous studies of athletes have shown a 75% to 79% rate of return to play after the procedure.Purpose:To define return-to-play rates in a cohort of elite collegiate and professional basketball players following osteochondral allograft of the knee.Study Design:Case series; Level of evidence, 4.Methods:Prospectively collected data from an institutional cartilage repair registry were retrospectively reviewed. Patients were eligible for inclusion if they were collegiate or professional basketball players at the time of surgery. Patient demographics, lesion size and location, and surgical details were collected. Postoperative magnetic resonance imaging scans were scored with the OCAMRISS system. Time to return to play and pre- versus postoperative player performance were determined with publicly available internet resources.Results:Eleven athletes (4 professional, 7 collegiate) with a total of 14 treated lesions (1 to the medial femoral condyle, 6 to the lateral femoral condyle, 5 to the trochlea, and 2 to the patella) were eligible for study inclusion. Mean lesion size was 509 mm2. All patients underwent OCA through an arthrotomy, with fresh grafts. The overall rate of return to play at the same level of competition was 80%. Median time to return to play was 14 months (range, 6-26 months). Among players with available statistics, there was no significant reduction in any performance category.Conclusion:OCA in elite basketball players results in an 80% return to previous level of competition, which is consistent with previous reports of athletes playing other sports. Osteochondral allografting is a reasonable option to consider for full-thickness cartilage lesions of the knee, even for elite jumping athletes.

Surgical and tissue engineering strategies for articular cartilage and meniscus repair

“…Both osteochondral autograft transfer and osteochondral allograft transplantation have produced high rates of long-term graft survival, as well as high degrees of reported patient satisfaction and return-to-play among athletes 26,[33][34][35] . For example, a 2016 systematic review found that ~90% of patients who underwent osteochondral autograft transfer had good or excellent outcomes at up to 10 years after surgery 19 .…”

Osteochondral Allograft Transplant of the Patella Using Femoral Condylar Allografts: Magnetic Resonance Imaging and Clinical Outcomes at Minimum 2-Year Follow-up

“…Multiple studies have demonstrated good long-term results, with improvements in both postoperative pain and function 2 , 10 , 28 and a reported 88% rate of return to sport, 14 , 15 including an 80% rate of return to play in professional and collegiate athletes. 3 Anatomically, medial femoral condyle (MFC) and patellar cartilage lesions are the most commonly encountered. 4 , 27 Although most of the existing outcomes literature has focused on condylar OCA, treatment of patellar lesions with OCA has been reported as well.…”

The cost-effectiveness of osteochondral allograft transplantation in the knee

“…Williams et al [ 66 ] have treated elite and other high-performance athletes, and Balaz et al [ 4 ] and Krych et al [ 36 ] have reported high proportions returning to high level performance.…”