Comparison of Fresh Osteochondral Autografts and Allografts

Abstract

The use of fresh allograft tissue to treat osteochondral defects eliminates morbidity associated with harvesting autograft tissue without compromising the results of the surgical procedure.

Treatment of Articular Cartilage Defects in the Goat with Frozen Versus Fresh Osteochondral Allografts: Effects on Cartilage Stiffness, Zonal Composition, and Structure at Six Months

“…Qualitatively, frozen allografts appear acellular by three months, compared with fresh allografts, which contain viable cells for as long as twelve months [12][13][14][15][16] . When compared with that in the nonoperative control knees, the confined compressive stiffness of the operatively treated knees was slightly reduced in the fresh allograft areas, and markedly reduced in the frozen allograft areas with increasing postoperative duration 12,13,15,19,20 . The reduction of cartilage load-bearing function was associated with proteoglycan content 15 ; however, other determinants of cartilage stiffness have not been investigated.…”

“…4 through 6). Previous allograft animal studies did not analyze depth-related variations in chondrocyte cellularity 14,15,18 and matrix content 13,14,[17][18][19][20] , which are important because chondrocytes exhibit zone-specific functions 30 . Appropriate zonal chondrocyte organization and proteoglycan synthesis rates in fresh allografts provided biological remodeling that served to preserve the articular surface, sustain bulk tissue properties (including cartilage fill, matrix content, and load-bearing function), maintain the bone-cartilage interface and underlying bone structure, and prevent progressive deterioration to graft collapse (Fig.…”

“…In contrast, cartilage of fresh allografts remains grossly normal for as long as twelve months, with only mild degenerative changes [14][15][16] . Gross observations are paralleled by histopathologic changes, including reduced (for frozen) and maintained (for fresh) safranin-O staining intensity [10][11][12][13][14][15][16][17][18][19][20][21] . Cartilage cellularity and load-bearing function have been analyzed in relatively few studies.…”

Treatment of osteochondral defects of the talus

“…408 Th e scans will be analyzed twice by a single physician, blinded to both treatment allocation and clinical outcome, measuring completeness, thickness, and level of the subchondral plate (i.e., fl ush, depressed, or proud). 154 Additionally, bone volume fi lling of the defect aft er 1 year will be measured, and graded as good (67% to 100%), moderate (34% to 66%), or poor (0% to 33%). 288 …”

Permeation of dimethyl sulfoxide into articular cartilage at subzero temperatures

“…Cartilage is described as an immunologically privileged tissue, and fresh osteochondral allografts have been proved to be effective and functional for transplantation (Chu et al, 1999;Aubin et al, 2001;Williams et al, 2007;Raikin, 2009). Furthermore, a recent study showed that fresh osteochondral autograft and fresh allograft tissues are not statistically different with respect to bony incorporation, AC composition, and biomechanical properties up to six months after implantation (Glenn et al, 2006). However, this kind of treatment is limited by the scarcity of healthy grafts and the time difference between donation and clinical use, which necessitates the construction of an osteochondral allograft bank to preserve the AC that is from cadaver tissue donors or which might be manufactured by tissue engineering in the future.…”