{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T17:34:12Z","timestamp":1783445652051,"version":"3.54.6"},"reference-count":35,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T00:00:00Z","timestamp":1705449600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T00:00:00Z","timestamp":1705449600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T00:00:00Z","timestamp":1705449600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T00:00:00Z","timestamp":1705449600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["clinicalkey.fr","clinicalkey.jp","arthroscopyjournal.org","clinicalkey.es","clinicalkey.com.au","clinicalkey.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the presence of host bone marrow edema (BME) surrounding osteochondral allograft (OCA) plugs on routine 6\u2010month postoperative magnetic resonance imaging (MRI) and to determine whether such BME is correlated with subsequent failure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The present study was approved under our institutional review board\u2013approved database (#2020\u20102123). We included patients who underwent cartilage repair with OCA for focal chondral and osteochondral defects of the distal femur by 2 senior surgeons between January 2016 and May 2021 with minimum 2\u2010year follow\u2010up. OCA is frequently performed with concomitant procedures, and therefore ligament reconstruction, meniscal surgery, and osteotomy were not exclusion criteria. Failure was defined as (1) poor clinical outcome with graft collapse on follow\u2010up MRI or second\u2010look arthroscopy, (2) primary OCA removal or revision, or (3) conversion to unicompartmental or total knee arthroplasty. Routine MRI scans were performed at 6 \u00b1 2 months postoperatively. All postoperative MRI scans were reviewed from our imaging record by 2 blinded fellowship\u2010trained orthopaedic surgeons. Patients were divided for analyses into 2 groups: BME \u226510 cm\n                      <jats:sup>3<\/jats:sup>\n                      versus BME &lt;10 cm\n                      <jats:sup>3<\/jats:sup>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 85 patients eligible for the study, 56 patients (30 female, mean age 31.69 \u00b1 11.34 years) had a minimum 2\u2010year follow\u2010up. Nonfailure cases had a mean clinical follow\u2010up of 3.13 \u00b1 0.93 years. The mean time from surgery to failure in our cohort was 1.67 \u00b1 0.91 years. There were 12 (21.4%) patients with BME \u226510 cm\u00b3 and 44 (78.6%) patients with BME &lt;10 cm\u00b3. No statistically significant differences were found between groups when compared for sex, age, body mass index, OCA size, time to MRI, mean follow\u2010up, number of plugs, graft location, diagnosis, previous surgeries, or concomitant procedures. All OCA failures of the study cohort were in the BME \u226510 cm\u00b3 group, representing 50% of this group (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). Kaplan\u2010Meier survival analysis with the log\u2010rank test demonstrated significant difference in survival distributions between groups (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). Patients who ultimately failed had a mean BME volume of 18.49 \u00b1 5.82 cm\n                      <jats:sup>3<\/jats:sup>\n                      , while the nonfailure group had a mean volume of 4.66 \u00b1 4.97 cm\n                      <jats:sup>3<\/jats:sup>\n                      (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). Cutoff values around 10 cm\u00b3 in receiver operating characteristic curve analysis demonstrated 100% sensitivity and close to 90% specificity for OCA failure diagnosis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Host BME with a volume greater than 10 cm\u00b3 on 6\u2010month postoperative MRI is predictive of an increased subsequent failure rate after OCA transplantation with a failure rate of 50%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, cohort study.<\/jats:p>\n                  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