High Short‐Term Failure Rate Associated With Decellularized Osteochondral Allograft for Treatment of Knee Cartilage Lesions
Bibliographic record
Abstract
Purpose To report the short‐term clinical and radiographic outcomes following the use of decellularized osteochondral (OC) allograft plugs in the treatment of distal femoral OC lesions. Methods An Institutional Review Board‐approved database with prospectively collected data was used to identify patients treated with the decellularized OC allograft plugs implant. Demographic information, patient‐reported outcomes, magnetic resonance imaging (MRI), and the number and type of reoperations were assessed. Failure was defined as revision surgery with removal of the implant. Patients were evaluated pre‐ and postoperatively using the Short Form‐36, Activity of Daily Living Score, International Knee Documentation Committee Subjective Evaluation, Cincinnati Knee Rating System, and Marx Activity Scale. MRIs were evaluated using the OsteoChondral Allograft MRI Scoring System. Results Thirty‐four patients were identified, with a mean age of 45 (±11.9) years; 71% were male. Fifteen (44%) patients had undergone prior ipsilateral surgical intervention. Mean defect size was 4 (±1.5) cm 2 , and median number of allografts per knee was 2 (range, 1‐5). Mean follow‐up duration was 15.5 months (range, 6‐24). Ten patients (29%) required revision surgery with removal of the implant. Implant survivorship was 61% at 2 years. Female gender was independently predictive of failure, with a hazard ratio of 9.4 (95% confidence interval [CI], 2.0‐58.9; P = .005). Defect size was also independently predictive of failure, with a hazard ratio of 1.9 per 1 cm 2 increase (95% CI, 1.2‐3.1; P = .005). MRIs obtained at 1 year postoperatively demonstrated significantly improved osseous integration ( P = .0086) and opposing cartilage ( P = .019) in the nonfailure group as compared with the failure group. Conclusions Based on the high short‐term failure rate observed in this study, the authors advise that a decellularized OC allograft plugs implant should be used with caution in the treatment of OC lesions of the knee, as similar outcomes have not been noted with other cartilage restoration techniques. Level of Evidence Level IV, therapeutic case series.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".