Bone Marrow Aspirate Concentrate Improves the Early Osseous Integration of Fresh Osteochondral Allografts in the Knee: A Randomized Controlled Trial.

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Study Summary

36 patients undergoing fresh osteochondral allograft (FOCA) transplantation for focal osteochondral lesions of the knee were randomized to receive bone marrow aspirate concentrate augmentation (BMAC) or no BMAC. The primary outcome was osseous integration assessed on computed tomography using the semiquantitative assessment computed tomography osteochondral allograft scoring system. Other outcomes included graft signal density, cleft formation, cystic changes, intra-articular fragments, International Knee Documentation Committee (IKDC) score, Kujala score, Western Ontario Meniscal Evaluation Tool (WOMET) score, and Tegner activity score. Computed tomography outcomes were assessed at 3, 6, and 12 months, while clinical outcomes were assessed at 6, 12, and 24 months. Overall, BMAC improved osseous integration at the host-graft junction at 3 months, but this advantage was no longer present at 6 or 12 months. Patient-reported outcomes were comparable between groups, suggesting that BMAC may accelerate early graft incorporation without providing superior short-term clinical outcomes.