Missouri osteochondral preservation system transplantation: Outcome scores from 24 months to 60+ months

doi:10.5312/wjo.114039

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World Journal of Orthopedics

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2218-5836

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Orthop. Sep 18, 2026; 17(9): 114039
Published online Sep 18, 2026. doi: 10.5312/wjo.114039

Table 1 Demographic data, %

	MOPS cohort (n = 29)
Mean age (years)	38.9 (21-58)
Mean BMI	28.94 (21.1-48.1)
Gender
Female	68.96
Male	31.03
Mean presurgical symptom duration (month)	14.0 ± 14.3 (range 1-62)
Chondral lesion site (n = 39)
Patella	53.8
Multiple unicompartmental sites	17.9
Medial femoral condyle	23.1
Lateral femoral condyle	10.3
Trochlear groove	7.7
Lateral tibial plateau	5.1
ICRS lesion (n = 38)
Grade 2	2.6
Grade 3	10.5
Grade 4¹	15.8
Grade 4A	57.9
Grade 4B	13.2

¹ Unspecified grade 4.

MOPS: Missouri osteochondral preservation system; BMI: Body mass index.

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Table 2 Prior surgeries

	MOPS cohort (n = 29)
Chondroplasty	20
Microfracture	9
Synovectomy	7
Meniscectomy	6
ACL reconstruction	4
MPFL reconstruction	4

ACL: Anterior cruciate ligament; MPFL: Medial Patellofemoral Ligament.

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Table 3 Progression of functional outcome scores from pre-operative to most recent follow-up

	Pre-operative	Final follow-up	P value
VAS frequency	8.69 ± 1.98	3.31 ± 2.84	< 0.001¹
VAS pain	5.36 ± 3.16	4.28 ± 2.75	0.082
IKDC score	32.18 ± 16.83	66.23 ± 19.92	< 0.001¹
Lysholm score	39.78 ± 19.3	69.48 ± 21.16	< 0.001¹
KOOS pain score	47.41 ± 22.33	80.75 ± 17.97	< 0.001¹
KOOS symptom score	48.58 ± 24.17	78.08 ± 19.90	< 0.001¹
KOOS ADL score	54.77 ± 23.60	87.07 ± 15.81	< 0.001¹
KOOS sports score	25.89 ± 23.02	62.93 ± 28.96	< 0.001¹
KOOS QOL score	21.55 ± 15.99	56.90 ± 25.02	< 0.001¹
PSF-12 score	33.18 ± 9.41	44.99 ± 11.27	< 0.001¹
MSF-12 score	47.98 ± 9.94	52.97 ± 9.13	0.009¹

¹Denotes statistical significance.

VAS: Visual analogue scale; IKDC: International Knee Documentation Committee; KOOS: Knee Injury and Osteoarthritis Outcome Subscale Scores; SF-12: Short Form-12; ADL: Activities of Daily Living; QOL: Quality of Life; PSF-12: Physical Short Form-12; MSF-12: Mental Short Form-12.

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Table 4 Patient-reported outcome measures (mean ± SD, P value)

	PreOp (n = 29)	3-6 months (n = 18)	6-12 months (n = 20)	12-24 months (n = 18)	24-36 months (n = 11)	36-60 months (n = 15)	60+ months (n = 11)
Pain frequency	8.69 ± 1.98	4.6 ± 2.8, P < 0.001¹	4.7 ± 2.9, P < 0.001¹	4.2 ± 3.0, P < 0.001¹	4.1 ± 2.5, P < 0.001¹	3.8 ± 2.8, P < 0.001¹	3.5 ± 3.2, P < 0.001¹
Pain severity	5.36 ± 3.16	4.5 ± 2.8, P = 0.295	4.6 ± 2.2, P = 0.083	5.0 ± 2.1, P = 0.195	5.2 ± 2.1, P = 0.371	4.3 ± 2.8, P = 0.018¹	3.8 ± 2.8, P = 0.042¹
IKDC function	32.18 ± 16.83	48 ± 15.9, P = 0.004¹	53.5 ± 18.0, P < 0.001¹	58.7 ± 21.7, P < 0.001¹	60.1 ± 20.6, P = 0.002¹	62.1 ± 20.5, P < 0.001¹	64.4 ± 22.1, P < 0.001¹
Lysholm	39.78 ± 19.3	62.3 ± 19.4, P < 0.001¹	64.3 ± 23.7, P < 0.001¹	72.6 ± 22.9, P < 0.001¹	68.8 ± 21.3, P < 0.001¹	65.3 ± 22.0, P < 0.001¹	66.6 ± 21.8, P < 0.001¹
KOOS pain score	47.41 ± 22.33	68.7 ± 19.6, P = 0.001¹	71.6 ± 20.7, P < 0.001¹	74.0 ± 22.7, P < 0.001¹	80.7 ± 20.5, P < 0.001¹	74.6 ± 20.5, P < 0.001¹	76.0 ± 18.4, P < 0.001¹
KOOS symptom	48.58 ± 24.17	64.6 ± 16.7, P = 0.010¹	70.1 ± 18.1, P < 0.001¹	75.1 ± 19.5, P < 0.001¹	78.4 ± 18.5, P < 0.001¹	74.0 ± 19.6, P = 0.001¹	75.0 ± 18.3, P < 0.001¹
KOOS ADL	54.77 ± 23.60	77.3 ± 18.8, P = 0.005¹	81.0 ± 18.9, P < 0.001¹	81.6 ± 19.8, P < 0.001¹	86.7 ± 20.1, P < 0.001¹	81.1 ± 15.9, P < 0.001¹	84.2 ± 15.4, P < 0.001¹
KOOS sport	25.89 ± 23.02	44.0 ± 25.3, P = 0.077	52.3 ± 25.4, P < 0.001¹	49.4 ± 24.1, P = 0.001¹	56.7 ± 26.7, P = 0.005¹	55.7 ± 31.2, P = 0.001¹	55.0 ± 32.4, P = 0.001¹
KOOS QOL	21.55 ± 15.99	41.4 ± 19.0, P < 0.001¹	45.9 ± 18.8, P < 0.001¹	48.0 ± 22.6, P < 0.001¹	56.0 ± 22.9, P < 0.001¹	51.3 ± 29.8, P = 0.001¹	51.7 ± 23.1, P = 0.001¹
PSF-12 score	33.18 ± 9.41	35.9 ± 8.4, P = 0.100	39.7 ± 7.9, P = 0.001¹	42.9 ± 10.4, P < 0.001¹	44.5 ± 10.9, P = 0.007¹	44.6 ± 9.3, P = 0.001¹	43.4 ± 13.1, P = 0.003¹
MSF-12 score	47.98 ± 9.94	55.7 ± 7.8, P = 0.002¹	48.5 ± 9.8, P = 0.467	50.0 ± 9.3, P = 0.405	50.9 ± 10.5, P = 0.200	50 ± 9.5, P = 0.139	56.7 ± 4.8, P = 0.001¹

¹Denotes statistical significance.

VAS: Visual analogue scale; IKDC: International Knee Documentation Committee; KOOS: Knee Injury and Osteoarthritis Outcome Subscale Scores; SF-12: Short Form-12; PSF-12: Physical Short Form-12 MSF-12: Mental Short Form-12; PreOp: Pre-operative.

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Table 5 Tibial osteotomy patient-reported outcome measures (mean ± STdev, P value)

	Pre-Op (n = 4)	3-6 months (n = 4)	6-12 months (n = 3)	12-24 months (n = 3)	24-36 months (n = 2)	36-60 months (n = 0)	60+ months (n = 2)
Pain frequency	8.5 ± 3.0	5.0 ± 3.6, P = 0.077	2.5 ± 0.9, P = 0.079	2.0 ± 2.6, P = 0.115	3.5 ± 2.1, P = 0.072	N/A	1.5 ± 2.1, P = 0.218
Pain severity	3.0 ± 4.8	3.5 ± 1.0, P = 0.431	3.2 ± 0.8, P = 0.406	4.0 ± 1.7, P = 0.446	4.5 ± 3.5, P = 0.479	N/A	2.5 ± 3.5, P = 0.371
IKDC function	44.2 ± 15.3	52 ± 12.7, P = 0.133	67.8 ± 13.6, P = 0.143	75.7 ± 14.9, P = 0.110	73.6 ± 27.6, P = 0.208	N/A	85.1 ± 9.8, P = 0.110
Lysholm	50.3 ± 14.4	62 ± 13.7, P = 0.010¹	85 ± 10.8, P = 0.040¹	89 ± 9.6, P = 0.043¹	70 ± 17, P = 0.162	N/A	85.5 ± 7.8, P = 0.174
KOOS pain	66.7 ± 18.7	75 ± 18.6, P = 0.194	83.8 ±13.9, P = 0.137	93.1 ± 1.4, P = 0.031¹	88.9 ± 15.7, P = 0.218	N/A	95.8 ± 5.9, P = 0.139
KOOS symptom	70.5 ± 19.4	71.4 ± 7.7, P = 0.467	82.1 ± 10.7, P = 0.261	89.3 ± 6.2, P = 0.105	85.7 ± 5.1, P = 0.178	N/A	96.4 ± 0, P = 0.045¹
KOOS ADL	82.4 ± 20.4	82 ± 18.6, P = 0.491	89 ± 13.4, P = 0.362	96.3 ± 1.9, P = 0.165	97.8 ± 3.1, P = 0.191	N/A	98.5 ± 2.1, P = 0.339
KOOS sport	40 ± 26.8	46.3 ± 39, P = 0.417	87.5 ± 1.5, P = 0.040¹	69.2 ± 14.6, P = 0.194	62.5 ± 38.9, P = 0.287	N/A	90 ± 7.1, P = 0.165
KOOS QOL	26.6 ± 11.8	40.6 ± 9.4, P = 0.139	44.8 ± 0.8, P = 0.254	62.5 ± 28.6, P = 0.143	71.9 ± 30.9, P = 0.124	N/A	56.3 ± 26.5, P = 0.290
PSF12 score	31.1 ± 10.1	33.6 ± 10, P = 0.377	45.4 ± 9.9, P = 0.098	45.8 ± 7.9, P = 0.019*	40.1 ± 18.5, P = 0.150	N/A	55 ± 3.2, P = 0.067
MSF12 score	56.2 ± 3.5	63.1 ± 4.4, P = 0.072	55.6 ± 5.3, P = 0.393	50.5 ± 16.8, P = 0.251	61.1 ± 1.7, P = 0.132	N/A	57.5 ± 1.9, P = 0.45

¹Denotes statistical significance.

VAS: Visual analogue scale; IKDC: International Knee Documentation Committee; KOOS: Knee Injury and Osteoarthritis Outcome Subscale Scores; N/A: Not applicable; SF-12: Short Form-12; PSF-12: Physical Short Form-12 MSF-12: Mental Short Form-12; PreOp: Pre-operative.

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Table 6 Complex multiple graft location patient-reported outcome measures (mean ± STdev, P value)

	Pre-Op (n = 7)	3-6 months (n = 7)	6-12 months (n = 5)	12-24 months (n = 5)	24-36 months (n = 5)	36-60 months (n = 2)	60+ months (n = 2)
Pain frequency	8.0 ± 2.1	5.3 ± 2.9, P = 0.078	4.9 ± 3.3, P = 0.046¹	3.9 ± 2.9, P = 0.007¹	3.6 ± 1.9, P = 0.006¹	4 ± 0, P = 0.102	5 ± 2.8, P = 0.121
Pain severity	5.1 ± 2.3	5.9 ± 3.1, P = 0.213	4.3 ± 2.3, P = 0.174	5.7 ± 2.2, P = 0.431	5.2 ± 1.6, P = 0.386	4 ± 0, P = 0.313	4 ± 2.8, P = N/A
IKDC function	36.1 ± 16.5	43.5 ± 14.8, P = 0.210	57.8 ± 14.6, P = 0.002¹	59.7 ± 19.3, P = 0.010¹	64.8 ± 9.5, P = 0.009¹	61.8 ± 3.7, P = 0.026¹	49.4 ± 11.4, P = 0.122
Lysholm	44.4 ± 24.4	65.4 ± 20.9, P = 0.074	71.9 ± 23.1, P = 0.001¹	78.6 ± 22.2, P = 0.012¹	79.8 ± 14.5, P = 0.007¹	70 ± 12.7, P = 0.090	56.5 ± 9.2, P = 0.109
KOOS pain score	44.0 ± 22.2	65.3 ± 16.8, P = 0.043¹	72.5 ± 20.8, P = 0.004¹	73.3 ± 32.2, P = 0.019¹	85.0 ± 9.9, P = 0.003¹	81.3 ± 8.8, P = 0.094	73.6 ± 13.7, P = 0.040¹
KOOS symptom	47.7 ± 24.9	64.5 ± 11.9, P = 0.084	71.4 ± 18.8, P = 0.009¹	74.3 ± 21.6, P = 0.024¹	78.6 ± 15.2, P = 0.026¹	84.8 ± 1.3, P = 0.054	60.7 ± 20.2, P = 0.124
KOOS ADL	51.7 ± 15.2	72.0 ± 21.0, P = 0.025¹	79.7 ± 22.4, P = 0.003¹	87.0 ± 11.7, P = 0.001¹	93.8 ± 8.3, P = 0.003¹	87.5 ± 5.2, P = 0.085	77.2 ± 9.4, P = 0.126
KOOS sport	25 ± 22.7	34.6 ± 14.9, P = 0.073	53.0 ± 15.7, P = 0.023¹	48.0 ± 14.4, P = 0.0345¹	64 ± 10.8, P = 0.013¹	61.3 ± 1.8, P = 0.024¹	45 ± 35.4, P = 0.187
KOOS QOL	23.2 ± 11.8	40.2 ± 13.4, P = 0.019¹	53.8 ± 13.9, P = 0.003¹	50.0 ± 23.0, P = 0.011¹	61.3 ± 10.3, P = 0.004¹	56.3 ± 26.5, P = 0.172	53.1 ± 13.3, P = 0.121
PSF12 score	33.0 ± 8.1	38.1 ± 7.2, P = 0.159	37.9 ± 7.8, P = 0.094	47.3 ± 9.0, P = 0.020¹	51.4 ± 4, P = 0.006¹	46.3 ± 2.8, P = 0.039¹	33.1 ± 0.5, P = 0.048¹
MSF12 score	47.4 ± 5.9	49.2 ± 6.0, P = 0.227	51.0 ± 10.5, P = 0.263	49.6 ± 7.2, P = 0.295	49.9 ± 5.8, P = 0.225	54.2 ± 1.7, P = 0.307	61.6 ± 9.2, P = 0.124

¹Denotes statistical significance.

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Table 7 Patellofemoral realignment patient-reported outcome measures (mean ± SD, P value)

	Pre-Op (n = 8)	3-6 months (n = 7)	6-12 months (n = 3)	12-24 months (n = 6)	24-36 months (n = 5)	36-60 months (n = 3)	60+ months (n = 3)
Pain frequency	8.5 ± 2.1	5.5 ± 3.1, P = 0.042¹	5.2 ± 3.4, P = 0.067	5.3 ± 2.9, P = 0.029¹	4.4 ± 2.4, P = 0.015¹	2.5 ± 2.2, P < 0.001¹	5.3 ± 1.5, P = 0.113
Pain severity	5.4 ± 3.4	5.3 ± 3.4, P = 0.416	5.8 ± 1.9, P = 0.134	5.9 ± 2.8, P = 0.312	6.0 ± 1.4, P = 0.163	2.5 ± 2.2, P = 0.095	6 ± 2, P = 0.317
IKDC function	32.5 ± 20.7	40.3 ± 12.4, P = 0.261	53.1 ± 12.2, P = 0.069	49.9 ± 18.5, P = 0.121	53.8 ± 13.5, P = 0.035¹	72.6 ± 15.6, P = 0.045¹	55.6 ± 19.8, P = 0.020¹
Lysholm	40.1 ± 23.6	64.4 ± 15.8, P = 0.026	75.5 ± 24.6, P = 0.074	69.5 ± 23.5, P = 0.040¹	67.4 ± 17.9, P = 0.003¹	84.8 ± 12.8, P = 0.036¹	61.7 ± 11.1, P = 0.045¹
KOOS pain score	40.3 ± 23.5	68.1 ± 15.6, P = 0.008¹	73.6 ± 23.7, P = 0.050¹	68.1 ± 28.0, P = 0.036¹	82.2 ± 15.2, P < 0.001¹	88.4 ± 9.8, P = 0.039¹	72.2 ± 8.3, P = 0.017¹
KOOS symptom	43.3 ± 30.0	63.0 ± 13.2, P = 0.044¹	66.7 ± 16.2, P = 0.110	65.3 ± 18.0, P = 0.062	77.1 ± 18.5, P = 0.008¹	79.8 ± 22.6, P = 0.038¹	66.7 ± 18.3, P = 0.122
KOOS ADL	50.2 ± 26.6	74.7 ± 16.8, P = 0.040¹	86.8 ± 19.2, P = 0.067	83.7 ± 16.6, P = 0.036¹	85.9 ± 15.4, P = 0.005¹	94.9 ± 4.6, P = 0.096	78.9 ± 13.2, P = 0.016¹
KOOS sport	28.1 ± 28.5	35.0 ± 21.4, P = 0.360	55.0 ± 8.7, P = 0.150	48.1 ± 18.1, P = 0.168	56 ± 29, P = 0.105	75.8 ± 18.9, P = 0.026¹	46.7 ± 25.2, P = 0.054
KOOS QOL	27.3 ± 18.6	39.7 ± 16.8, P = 0.026¹	50.0 ± 9.4, P = 0.045¹	45.5 ± 16.8, P = 0.058	46.3 ± 9.5, P = 0.012¹	76 ± 23.5, P = 0.005¹	41.7 ± 9.5, P = 0.016¹
PSF12 score	34.2 ± 13.0	34.6 ± 7.9, P = 0.436	39.5 ± 8.1, P = 0.072	40.5 ± 8.9, P = 0.072	43 ± 6.5, P = 0.135	50.3 ± 4.1, P = 0.029¹	40.1 ± 12.7, P = 0.106
MSF12 score	46.3 ± 10.8	54.0 ± 9.5, P = 0.019¹	57.5 ± 4.0, P = 0.001¹	52.1 ± 8.9, P = 0.394	51.7 ± 9, P = 0.294	54.4 ± 5.1, P = 0.186	49.5 ± 11.5, P = 0.263

¹Denotes statistical significance.

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Citation: Desai B, Willard JG, Assid E, Hall C, Renshaw A, Schoofs E, Wilder JH, Hatcher L, Tupler R, Jones D. Missouri osteochondral preservation system transplantation: Outcome scores from 24 months to 60+ months. World J Orthop 2026; 17(9): 114039
URL: https://www.wjgnet.com/2218-5836/full/v17/i9/114039.htm
DOI: https://dx.doi.org/10.5312/wjo.114039

Desai B, Willard JG, Assid E, Hall C, Renshaw A, Schoofs E, Wilder JH, Hatcher L, Tupler R, Jones D. Missouri osteochondral preservation system transplantation: Outcome scores from 24 months to 60+ months. World J Orthop 2026; 17(9): 114039 [DOI: 10.5312/wjo.114039]

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