Osteochondral Allograft Transplantation for Large Osteochondral Lesions of the Femoral Head in Young Patients
Bibliographic record
Abstract
INTRODUCTION: Osteochondral lesions of the femoral head in young patients are a rare but challenging clinical problem. Fresh osteochondral allograft (OCA) transplantation has been proposed as one potential treatment option that may improve function and delay hip arthroplasty. However, there is a paucity of published data. The purpose of this study was to assess allograft survivorship and patient-reported outcomes in patients undergoing OCA transplantation for osteochondral lesions of the femoral head. METHODS: Sixteen patients (16 hips) who underwent femoral head OCA transplantation for the treatment of avascular necrosis between 1985 and 2021 were included. Mean age was 21.0±10.1 years (range: 11.6 to 43.5 y) and 56% were male. Mean allograft diameter was 26.9±4.2 mm (range: 20 to 35 mm) and mean thickness was 10.2±3.2 mm (range: 5 to 15 mm). We evaluated the frequency and type of further surgery, Hip Disability and Osteoarthritis Outcome Score (HOOS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), modified Harris Hip Score (mHHS), and UCLA function score. Clinical failure was defined as conversion to total hip arthroplasty. RESULTS: Six of 16 hips (38%) experienced clinical failure (5 total hip arthroplasties and 1 resurfacing arthroplasty), with a mean time to failure of 3.6±2.6 years (range: 1.0 to 8.5 y). Allograft survivorship for patients under age 18 was 85.7% at 3 years and 42.9% at 5 years compared with patients over age 18 years who experienced a survivorship of 66.7% at 3 and 5 years ( P =0.911). Of the remaining 10 hips, the mean follow-up duration was 4.1 years (range: 1.9 to 7.4 y). At the latest follow-up, mean HOOS was 74.5±20.2 (range: 48.6 to 100), mean WOMAC was 79.9±18.2 (range: 56.1 to 100), mean mHHS was 74.9±20.9 (range: 41 to 100.1), and mean UCLA score was 7.0±2.7 (range: 4 to 10). CONCLUSIONS: Young patients with large chondral lesions of the femoral head may benefit from fresh OCA transplantation, but failure rates remain quite high for this challenging patient population. OCA can be considered as a useful treatment option that preserves function and delays the need for arthroplasty in young individuals with osteochondral lesions of the femoral head.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| 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) | 0.000 | 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 teacher head, 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".