Our next paper will be clinical outcomes and return to sport following patellofemoral osteochondral allograft with and without concomitant tibial tubercle osteotomy, a retrospective cohort by Dr. Campbell. All right. Good morning, everyone. Thank you for giving us the opportunity to present our work. We have nothing relevant to disclose in regards to this project. So as you're all well aware, patellofemoral osteochondral defects are a common cause of anterior-based knee pain. Patellofemoral osteochondral allografts have shown favorable outcomes in the short term, but we have poor long-term survivorship. MACI, combined with a tibial tubercle osteotomy, has shown excellent outcomes. However, very limited data exists with combined osteochondral allograft in the patellofemoral compartment and unload in tibial tubercle osteotomy. So to our knowledge, there are no high-quality studies comparing the clinical outcomes and functional outcomes of patients undergoing patellofemoral osteochondral allograft transplantation with and without tibial tubercle osteotomy. So the aims of our study were to evaluate the rate of graft failure, return to support, clinical outcomes in these patients who have isolated patellofemoral osteochondral allografts and those with concomitant tibial tubercle osteotomy. This is a retrospective review of 35 patients who underwent these procedures, exclusion criteria, any revision, osteochondral allograft, any concomitant patella stabilization procedure or history of ipsilateral tibial tubercle osteotomy. We defined our graft failures as any failure in MRI, i.e., any frame or delamination, any revision, cartilage restoration procedure, including chondroplasty, or any conversion to a joint replacement. Collected PROSCORES, looked at VAS, and returned to support data as well. We collected imaging data, looked at TTT g-distance, looked at trochlear dysplasia. We looked at lesion characteristics, and we also collected information, whether it was orthotopic or non-orthotopic grafts that were eventually used. Here are the demographics. The most important finding here is that our combined procedure group were more female, 85% combined, compared to 41%. Our patients who had concomitant osteotomy also had higher TTT g-distance, not surprising. The graft failure rate, although this was not statistically significant, it was trending a little bit more towards the isolated group, having a higher failure rate, rather than the combined osteochondral allograft and tibial tubercle osteotomy. Here are the lesion locations in isolated group, mainly medial patella and lateral trochlear, while the combined group had mainly lateral patella and central patella defects. In terms of outcomes, the patients who were able to return to support, there was a higher report of VAS pain at baseline, and also with return to support in the patients with combined procedures, we found that the isolated patella osteochondral allograft group had a higher CRUS score. However, on a multivariate regression analysis, we were controlled for age, BMI, perioperative pain level, TTO was no longer a risk factor for difference in CRUS score. All of our patients met the MCID for VAS pain level, about 88% of the patients, 62% of the patients were able to return to support, and there was no difference in return to support rate in the isolated patella femoral osteochondral allograft group versus those with combined procedure. So limitations of the study, small sample size, as a retrospective design. We had short-term follow-up, average follow-up was 32 months, and patients were able to have comparable return to play rate and comparable graph failure rate. So both cohorts exhibited significant improvements in their pre- to post-op pain level, and although not statistically significant, only one patient who had a combined patella femoral osteochondral allograft and concomitant tibial tube glossotomy had a graph failure, while five in the isolated patella femoral osteochondral allograft group had a failure. Thank you.

retrospective cohort study

clinical outcomes

return to sport

patellofemoral osteochondral allograft

tibial tubercle osteotomy