Osteochondral Allograft Transplantation Operation in Turkey and Intensive Physiotherapy and Rehabilitation Programme

Currently, there is no universally accepted gold standard surgical method for cartilage defects, and osteochondral allograft (OCA) transplantation has emerged as a unique and promising option in recent years. Similarly, no standardized physiotherapy protocol has been developed for postoperative rehabilitation of these patients. Therefore, this study aims to provide valuable insights into both surgery and physiotherapy and rehabilitation strategies. Between July 2019 and June 2024 ten fresh OCA transplantations were performed (mean follow-up: 26.1 months (12–63). The inclusion criteria comprised young patients, between 15 and 45 years of age, with traumatic or acquired osteochondral lesions in the knee, chondral or osteochondral lesions larger than 4 cm 2 , and chondral or osteochondral lesions that failed previous treatment for articular cartilage repair. The mean age was 30.3 ± 5,7 (6M;4F). Osteochondral tissues were harvested from donors within 24 hours of donor death and then processed. Donors age between 18 to 35 years with grossly healthy articular cartilage without any joint surgery was accepted as a graft. Patients included in an intensive physiotherapy program (application of Game Ready, electrotherapy, exercises and taping) postoperatively. Patients were evaluated at four time points: preoperatively, at 8 week (after completing physiotherapy program), 6-month postoperative and 1-year postoperative follow-up. Pain outcomes were measured using the Visual Analog Scale (VAS), while functional outcomes were assessed with the Oxford Knee Score, the International Knee Documentation Committee (IKDC) form, and the Knee Injury and Osteoarthritis Outcome Score (KOOS). Magnetic resonance imaging (MRI) was evaluated postoperatively at >12 months follow-up to evaluate any sign of graft failure. The mean graft area was 5.1cm 2 (between 2.5 to 7.5cm 2 ). There was no sign of graft failure in the cases. There was significant improvement in VAS, IKDC, KOOS, Oxford scores (p=0.00).A significant change was observed in VAS and KOOS scores from baseline to 6 months compared to the period from 6 months to 1 year (p=0.005, p=0.001). Mean changes after 6 months from baseline in VAS and KOOS were (X? = 4,5, X? = 32,4 respectively). There was no sign of graft failure in the cases in the MRI evaluations. OCA transplantation was effective for people with knee cartilage defects. Physiotherapy program was found to be particularly effective during the first 6 months, interms of functional outcomes, pain levels, and muscle strength parameters. Full ROM and muscle strength were achieved at the 2-month postoperative assessments.