Background: Osteochondral allograft (OCA) transplantation is an established surgical intervention for full-thickness chondral defects. Standard preservation (SP) protocols currently allow for OCAs to be stored for a maximum of 28 days after procurement before significant chondrocyte death. An alternative protocol, the Missouri Osteochondral Allograft Preservation System (MOPS), has been shown to allow for grafts to be stored for twice the maximum time allotment as SP. Purpose: To compare clinical outcomes in patients who have undergone OCA transplantation utilizing the extended storage capabilities of the MOPS versus SP protocols. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent OCA transplantation from 2012 to 2018 were retrospectively identified. Patients without appropriate follow-up, postoperative outcomes, or necessary preoperative imaging were excluded. All patients had at least 2 years of follow-up data. Patient characteristics, outcomes, and graft information were compared between patients who received grafts preserved by MOPS versus SP as previously defined. Results: In total, 64 patients were included: 25 were in the MOPS group and 39 in the SP group. Members of the MOPS group were significantly younger at the time of surgery than those in the SP group (28.6 ± 10.7 years vs 36.7 ± 10.9 years; P = .005). In total, 78 grafts were analyzed with 39 grafts in the MOPS group and 39 in the SP group. Grafts in the MOPS group had significantly longer (mean, 50.03 days) storage duration than grafts in the SP group (mean, 23.18 days) ( P < .001). Preoperative patient-reported outcomes showed no statistically significant differences between the Knee injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS, JR) values, International Knee Documentation Committee (IKDC) scores, Physical Component Summary (PCS-12) scores, and Mental Component Summary (MCS-12) scores. Two-year outcome between groups showed no statistically significant differences in mean KOOS, JR values (81.4 ± 14.1 in the MOPS group vs 78.5 ± 16.2 in the SP group; P = .467), IKDC scores (74.3 ± 19.8 in the MOPS group vs 66.4 ± 18.4 in the SP group; P = .128), PCS-12 scores (48.7 ± 9.94 in the MOPS group vs 48.0 ± 9.83 in the SP group; P = .683), and MCS-12 scores (53.4 ± 8.92 in the MOPS group vs 50.6 ± 11.8 in the SP group; P = .583). There were no statistically significant differences in failure rates (20% in the MOPS group vs 17.95% in the SP group; P = .838) or complication rates (8% in the MOPS group vs 5.13% in the SP group; P = .643). Conclusion: OCAs preserved using the MOPS can be stored at greater than twice the storage duration of grafts preserved with SP techniques without a significant difference in postoperative outcomes.
Destine et al. (Thu,) studied this question.