🎯 Título: Reconstrucción de LCA con injerto de cartílago: resultados a 2 años
📌 En breve: Combinar la reconstrucción de LCA con un trasplante de cartílago (OCA) demoró el regreso al deporte pero logró resultados funcionales similares a la reconstrucción de LCA sola a los 2 años.
🔬 Puntos clave:
### El estudio
Estudio de cohorte retrospectivo con 43 pacientes que recibieron reconstrucción de LCA más trasplante osteocondral de aloinjerto (OCA), emparejados por edad y sexo con 43 pacientes que solo recibieron reconstrucción de LCA.
### Diferencias entre grupos
Los pacientes del grupo OCA tenían un nivel de actividad previo a la lesión más bajo (puntaje Marx 3,9 vs. 9,6; p < 0,001) y tardaron más en volver al deporte (9,1 vs. 7,9 meses; p = 0,040). Sin embargo, no hubo diferencias en las medidas de función al momento del regreso al deporte.
### A los 2 años
No hubo diferencias significativas entre grupos en la puntuación funcional SANE (85,4 vs. 87,0), en la tasa de nueva lesión del injerto (4,7% vs. 2,3%) ni en la tasa de retorno al nivel previo de deporte (69,8% vs. 72,1%). El 83,7% de los pacientes con OCA pudo volver a deportes de nivel 1 a 3.
🎯 Aplicación clínica para LATAM: Cirujanos ortopédicos de la región pueden usar estos datos para orientar expectativas realistas en pacientes que requieren reparación de cartílago junto con la reconstrucción de LCA: la recuperación funcional es comparable, aunque más lenta.
⚠ Limitaciones: Es un estudio retrospectivo de un solo cirujano, con muestra pequeña (43 pacientes por grupo), lo que limita la generalización a otros centros y cirujanos.
Background
Osteochondral allograft transplantation (OCA) has been established as a viable restorative chondral procedure, although few studies have examined its effectiveness in the setting of anterior cruciate ligament (ACL) reconstruction.
Purpose
To compare self-reported function and return-to-sport rates after ACL reconstruction with OCA to those of matched controls undergoing isolated ACL reconstruction.
Study design
Cohort study; Level of evidence, 3.
Methods
A retrospective matched cohort study was conducted utilizing a single-surgeon database of patients undergoing ACL reconstruction between 2016 and 2021. Included patients were 15 to 70 years of age, underwent ACL reconstruction with OCA, and desired to return to sport. Patients were age and sex matched to a cohort of patients who underwent isolated ACL reconstruction. Baseline characteristics were collected along with preinjury Marx score and surgical details. Outcomes at time of return to sport included self-reported function, time to return to sport, range of motion, and single-leg squat and hopping performance. Two-year outcomes included Single Assessment Numeric Evaluation (SANE) scores, return-to-sport rates, and reinjury rates. Between-group differences were analyzed utilizing chi-square analyses and 1-way analysis of variance with an a priori α value of .05.
Results
A total of 43 patients who underwent ACL reconstruction with OCA were identified and matched to 43 patients who underwent isolated ACL reconstruction. Patients in the ACL reconstruction with OCA group reported lower preinjury Marx scores (3.9 ± 5.7 vs 9.6 ± 5.9; P < .001). The ACL reconstruction with OCA group demonstrated a longer time to return to sport (9.1 ± 4.1 months vs 7.9 ± 3.4 months; P = .040); however, no differences existed between groups for all self-reported and objective outcomes at the time of return to sport. At 2 years, no differences existed regarding SANE scores (85.4 ± 12.1 vs 87.0 ± 13.5; P = .334), ACL graft reinjury rate (4.7% vs 2.3%; P = .481), and return to prior level of sport rates (69.8% vs 72.1%; P = .387).
Conclusion
Patients undergoing ACL reconstruction with OCA demonstrate similar self-reported function and return-to-sport rates, along with a delayed time to return to sport, to those undergoing isolated ACL reconstruction. A majority (83.7%) of patients undergoing ACL reconstruction with OCA can return to level 1 to 3 sports with low graft failure rates.
Cómo citar:
Lowe WR, Gregory B, Martin C, Buckner M, Auten JC, Kleihege J, Bailey L, Higbie S. (2026).
Two-Year Outcomes of ACL Reconstruction With Osteochondral Allograft Transplantation Versus Isolated ACL Reconstruction: A Matched Cohort Study.. Orthopaedic journal of sports medicine.
DOI: 10.1177/23259671261463928 ↗ PMID: 42471996 ↗ Acceso al paper: Ver completo ↗
