Study Compares Snowman vs. Single-Plug Osteochondral Allografts: Insights from Dr. Robert LaPrade

A recent study led by Brian J. Cole, MD, MBA, and colleagues at Rush University Medical Center compared outcomes in 26 patients treated with a snowman osteochondral allograft versus 52 patients who received a single-plug osteochondral allograft. The findings showed no significant difference in achieving minimal clinically important difference or patient-acceptable symptom state between the two groups. Both demonstrated meaningful improvements in postoperative scores, including IKDC, Lysholm, KOOS, and SF-12 physical function. The overall failure rate in each group was reported at 19.2%.

While historically it was believed that single-plug osteochondral allografts offered superior outcomes due to concerns about snowman graft stability, the study found that patients with the snowman technique experienced a faster time to failure—averaging 1.7 years compared to 6.6 years for single-plug grafts.

Dr. Robert LaPrade, internationally recognized orthopedic knee surgeon, emphasized the importance of caution when interpreting these results:

“This study comes from a group with excellent surgical techniques and patient selection,” Dr. LaPrade noted. “However, other research has shown higher failure rates for the snowman technique. When selecting between approaches, surgeons should choose what works best in their own hands and be especially cautious with early rehabilitation. Progressing impact activity too quickly—particularly with the snowman technique—may increase the risk of graft failure.”

This research reinforces the need for individualized surgical decision-making and careful postoperative rehabilitation protocols to optimize long-term outcomes for patients undergoing osteochondral allograft procedures.

You can read the original Healio post here: Multiplug, single-plug techniques had comparable outcomes for osteochondral defects

With the original research here:  Comparison of Snowman and Single-Plug Circular Osteochondral Allograft Transplantation Techniques for Similarly Sized Defects: A Matched Cohort Analysis