Can Fresh Osteochondral Allografts Restore Function in Juveniles With Osteochondritis Dissecans of the Knee?

Abstract

Background Failure of initial treatment for juvenile osteochondritis dissecans (OCD) may require further surgical intervention, including microfracture, autograft chondrocyte implantation, osteochondral autografting, and fresh osteochondral allografting. Although allografts and autografts will restore function in most adults, it is unclear whether fresh osteochondral allograft transplantations similarly restore function in skeletally immature patients who failed conventional treatment. Questions/purposes Therefore, we determined function in (1) daily activity; (2) sports participation; and (3)

Large Fresh Osteochondral Allografts of the Knee: A Systematic Clinical and Basic Science Review of the Literature

“…[4][5][6][7][8][9][10][11][12][13][14] There were 374 knees in 358 patients. Demographic data are reported in Table 2.…”

“…0 1 manipulation under anesthesia Giorgini et al 11 Improvement in both objective and subjective IKDC scores 1 UKA 2 (1 pain for 3 mo, 1 removal of loosen screw) Lyon et al 12 Return to sports at 9-12 mo, incorporation of graft on radiographs at 12 mo 0 1 persistent pain Levy et al 13 The survivorship rate was 89% at 5 yr, 82% at 10 yr, 74% at 15 yr, and 66% at 20 yr. 15 2012 Goats (15) Effect of allograft storage on macroscopic structure, cellular and matrix fixed cartilage composition, and biomechanical function of cartilage At 12 mo of follow-up, features of osteochondral allografts stored at 4 C for 14 d or 28 d were similar but were inferior to those of fresh grafts and better than those of frozen grafts. Cellularity, matrix content, and structural properties were reduced.…”

Treatment of a Lateral Tibial Plateau Osteochondritis Dissecans Lesion With Subchondral Injection of Calcium Phosphate

“…[8][9][10] However, in patients in whom conservative management has failed, surgical techniques include defect debridement and loose body removal, 11 transchondral and retrograde drilling, 12 in situ fixation, 13 microfracture, 14 autologous chondrocyte implantation, 15 and osteochondral grafting. 16,17 A new method, which is the focus of our technical note and video, is the use of an osteoconductive bone substitute (calcium phosphate) injected into the subchondral bone region. This technique is appropriate when the subchondral bone is intact (not unstable) and when patient symptoms match the location of subchondral edema noted on magnetic resonance imaging (MRI).…”

Surgical treatment for osteochondritis dessicans of the knee

“…This technique has been successful in several studies [20,53,54]. A recent study examined the use of osteochondral allografts in 11 juveniles with OCD of the knee and found 100 % of patients were able to return to sports with improved functional scores at an average of 24 months postsurgery [55]. This study suggests osteochondral allografts are an option for patients with juvenile OCD.…”