OC Allograft or bicompartmental PKR

03-09-2009, 08:29 AM

Hi yall, 40 year old mom who works as a nurse. Had a slip and fall 8 months ago, and got an oc impaction fracture of the distal MFC. OS recommended MFX surgery, ok I didnt know a lot about it (should of researched it) had the surgery and was in more pain than before suregery after 4 months of pain OS ordered another MRI turns out the MFX FAILED, ok what now? He refered me to a sports med specialist at Baptist Hospital (world renowed). I had the appt with her the first of the week, she said My defect is large and MFX shouldnt have even been attempted. It is 3cm x 1.5 cm, she recommended Osteochondral Allograft, due to the fact that my defect is too large for OATS autograft, and she feels like ACI is not a viable option because my defect is grade 4 and involves a fracture of the bone. However she wants to discuss my case with one of her partners due to the fact I have patellofemoral OA, and may benefit from a bicompartmental PKR. I really really dont want to go that route, Ive researched it alot and it just dont sit well with me. Anyone in the same boat as me or with some advise for me I would really appreciate it. Thank you guys in advance for #1 listen to me ramble and #2 giving me some advice.
Peace & Love
Michele

11-13-2011, 05:14 PM

Wow, your story is almost the same as mine! I'm a 45 year old O.T., had a riding accident 20 years ago and sustained a compression fracture to the lateral femoral condyle of my left knee. Have had a few scopes to remove loose bodies and tidy up a bit, but it has been getting slowly and progressively more painful over the years. My defect is into the subchondral bone (doc didn't grad it for me though), and about 3cm x 1cm in area. Too big for mosaicplasty.

So the Dr. at Mount Sinai in Toronto (A. Gross) is planning to do an osteochondral allograft transplant with a medial tibial osteotomy. He is apparently a pioneer in this procedure, so I believe I'm in good hands. Haven't had it yet -- just waiting for donor tissue that is a match (feels rather morbid).

I asked him about hemi-knee replacements and he said no for 2 reasons: My age - they hate to do a HKR/TKR too young, because you only get so many of those in a lifetime. Also, because my defect is lateral, and lateral hemi-knees aren't done very commonly (outpatient physio a the hospital where I work has only ever seen one!). So he is very firm that the allograft is my best/only option at this point.

Hope this helps.

OC Allograft or bicompartmental PKR

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