Vishal Sundaram<\/b><\/strong><\/p>\n<\/div>\n<\/div>\n Jazrawi, along with Vishal Sundaram<\/b> and colleagues, retrospectively reviewed data from 103 patients who underwent patellofemoral osteochondral allograft transplantation with (n = 39) or without (n = 64) a tibial tubercle osteotomy (TTO) between 2001 and 2023. In his presentation, Sundaram said the primary outcome was graft failure, defined as progression to arthroplasty, revision cartilage surgery, subchondral collapse on imaging or failed graft incorporation on second-look arthroscopy, and secondary outcome was all-cause reoperation, defined as any subsequent ipsilateral knee surgery.<\/p>\n
\u201cWe compared all these variables between our groups, including Kaplan-Meier survivorship to adjust for variable follow-up time,\u201d Sundaram, fourth-year medical student at NYU Langone Health, said in his presentation. \u201cWe performed an identical subanalysis with propensity-matched groups.\u201d<\/p>\n
According to Sundaram, graft failure rates did not differ in patients who underwent patellofemoral osteochondral allograft transplantation with and without TTO, with a Kaplan-Meier survivorship of 95% at 2-year follow-up. However, patients who received TTO had a reoperation-free survivorship rate of 67% at 2 years compared with 82% in patients who did not receive TTO.<\/p>\n
\u201cThis reoperation difference was, of course, largely driven by TTO-related hardware complications, as one may expect,\u201d Sundaram said.<\/p>\n
When patients were matched for sex, alignment parameters and lesion characteristics, Sundaram said there were no significant difference in graft failure or reoperation.<\/p>\n
\u201cTo identify the factors that did predict reoperation or failure, we brought it back to our original unmatched cohort and, in the [osteochondral allograft] only group, we found a larger total graft diameter \u2014 specifically greater than 27.5 mm \u2014 was significantly predictive of graft failure,\u201d Sundaram said.<\/p>\n
Although graft diameter greater than 21 mm and the presence of multiple lesions were associated with increased risk for reoperation in the TTO group, Sundaram said graft size was not associated with graft failure.<\/p>\n
\u201cSurgeons should carefully weigh the risks of additional surgery when considering augmentation of a patellofemoral osteochondral allograft transplantation with a TTO for graft preservation,\u201d Sundaram said.<\/p>\n
For more information:<\/h2>\n Laith M. <\/b>Jazrawi<\/b>, MD<\/b>, FAAOS<\/b>,<\/b> and Vishal Sundaram<\/b> wish to be contacted through Marlene Naanes at marlene.naanes@nyulangone.org.<\/p>\n\n
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Published by:<\/span>\n
Sources\/Disclosures<\/h3>\n Source: <\/h2>\n Sundaram V, et al. Paper 509. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 2-6, 2026; New Orleans.<\/p>\n
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