Osteochondral Graft Size Is Significantly Associated With Increased Force and Decreased Chondrocyte Viability

Walczak, Brian E.; Nies, Matthew S.; Trask, Darrin J.; Hetzel, Scott; Roney, Patrick; Squire, Matthew W.; Baer, Geoffrey S.

doi:10.1177/0363546517748906

Cited by 8 publications

(10 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The ideal depth of the allograft should be limited to 6 to 10 mm depending on the size and location of the graft. 91 0.00 100.00…”

Section: 86mentioning

confidence: 99%

“…In this regard, higher impact loads may be encountered when the graft is thicker than 10 mm and when there is a >2-mm difference between the graft and recipient hole, and thus, thinner plugs are now recommended that match the depth of the socket. 71,91 Laboratory studies demonstrated that high-impact loads adversely affect cell viability, with less than 50% to 70% of the cells remaining viable in that setting. 71,91 The load of impact has a larger influence on chondrocyte death than the number of impacts.…”

Section: Graft and Surgical Technique Considerationsmentioning

confidence: 99%

“…71,91 Laboratory studies demonstrated that high-impact loads adversely affect cell viability, with less than 50% to 70% of the cells remaining viable in that setting. 71,91 The load of impact has a larger influence on chondrocyte death than the number of impacts. Thus, multiple low-load taps are preferred over single high-load taps if impaction cannot be avoided.…”

Section: Graft and Surgical Technique Considerationsmentioning

confidence: 99%

See 2 more Smart Citations

An Expert Consensus Statement on the Management of Large Chondral and Osteochondral Defects in the Patellofemoral Joint

Chahla

Hinckel

Yanke

et al. 2020

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background: Cartilage lesions of the patellofemoral joint constitute a frequent abnormality. Patellofemoral conditions are challenging to treat because of complex biomechanics and morphology. Purpose: To develop a consensus statement on the functional anatomy, indications, donor graft considerations, surgical treatment, and rehabilitation for the management of large chondral and osteochondral defects in the patellofemoral joint using a modified Delphi technique. Study Design: Consensus statement. Methods: A working group of 4 persons generated a list of statements related to the functional anatomy, indications, donor graft considerations, surgical treatment, and rehabilitation for the management of large chondral and osteochondral defects in the patellofemoral joint to form the basis of an initial survey for rating by a group of experts. The Metrics of Osteochondral Allografts (MOCA) expert group (composed of 28 high-volume cartilage experts) was surveyed on 3 occasions to establish a consensus on the statements. In addition to assessing agreement for each included statement, experts were invited to propose additional statements for inclusion or to suggest modifications of existing statements with each round. Predefined criteria were used to refine statement lists after each survey round. Statements reaching a consensus in round 3 were included within the final consensus document. Results: A total of 28 experts (100% response rate) completed 3 rounds of surveys. After 3 rounds, 36 statements achieved a consensus, with over 75% agreement and less than 20% disagreement. A consensus was reached in 100.00% of the statements relating to functional anatomy of the patellofemoral joint, 88.24% relating to surgical indications, 100.00% relating to surgical technical aspects, and 100.00% relating to rehabilitation, with an overall consensus of 95.5%. Conclusion: This study established a strong expert consensus document relating to the functional anatomy, surgical indications, donor graft considerations for osteochondral allografts, surgical technical aspects, and rehabilitation concepts for the management of large chondral and osteochondral defects in the patellofemoral joint. Further research is required to clinically validate the established consensus statements and better understand the precise indications for surgery as well as which techniques and graft processing/preparation methods should be used based on patient- and lesion-specific factors.

show abstract

“…The ideal depth of the allograft should be limited to 6 to 10 mm depending on the size and location of the graft. 91 0.00 100.00…”

Section: 86mentioning

confidence: 99%

Section: Graft and Surgical Technique Considerationsmentioning

confidence: 99%

Section: Graft and Surgical Technique Considerationsmentioning

confidence: 99%

See 1 more Smart Citation

An Expert Consensus Statement on the Management of Large Chondral and Osteochondral Defects in the Patellofemoral Joint

Chahla

Hinckel

Yanke

et al. 2020

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

show abstract

“…Longer grafts were found to require an increased number of insertional impacts and cumulative impact force detrimental to surface chondrocyte viability and graft survival. [12][13][14] Studies exist evaluating the biomechanical properties of OCAs of 7 mm in depth and longer, but no study has clearly defined the minimal graft depth required to resist deforming forces. [15][16][17] Deforming forces leading to graft protrusion or subsidence of more than 1 mm can lead to unfavorable outcomes and fibrocartilaginous, rather than osteochondral incorporation.…”

mentioning

confidence: 99%

“…1,4,16 The utilization of shallower grafts, still capable of resisting deforming forces, may allow for less host autoimmune response, less surface chondral damage secondary to insertion forces, and less recipient site morbidity. 4,11,12 In addition, pulsatile lavage (PL) of OCAs is commonly performed to minimize residual antigenic factors in an attempt to decrease immunogenic material as well as increase volume for host osseous integration. 1,4 Allograft empty marrow volume was found to increase from 36 to 55% after fresh OCAs were subjected to 45 to 120 second periods of PL.…”

mentioning

confidence: 99%

Osteochondral Allograft Transplantation: Identifying the Biomechanical Impact of Using Shorter Grafts and Pulsatile Lavage on Graft Stability

et al. 2018

View full text Add to dashboard Cite

This study seeks to identify the ability of shorter osteochondral allografts (OCAs) to resist displacement/failure. Additionally, this study seeks to evaluate the effect of pulsatile lavage (PL) on the biomechanical stability of the OCA. Fifteen-millimeter diameter, human cadaveric, OCAs of 4, 7, and 10 mm in depth were harvested for comparison of resistance to compressive and tensile loads. For each group, seven specimens were subjected to tensile loads and three specimens subjected to compressive loads until failure (pullout or subsidence). An additional study group of 10 pulsatile-lavaged OCAs of 15 mm in diameter and 7 mm in depth were introduced for comparison to the original 7 mm depth OCA group. The average tensile forces for failure for the 4, 7, and 10 mm plugs were 23.74, 199.57, and 197.69 N, respectively (p = 1.5 × 10−5). After post hoc analysis of the tensile groups, significant differences in the mean tensile force to failure were appreciated between the 4 and 7 mm groups (p = 4.12 × 10−5) and the 4 and 10 mm groups (p = 1.78 × 10−5) but not between the 7 and 10 mm groups (p = 0.9601). There were no significant differences between the average tensile forces resulting in failure for the 7 mm and 7 mm PL groups (199.57 and 205.2 N, p = 0.90) or compressive forces to failure, respectively (733.6 and 656 N, p = 0.7062). For OCAs of 15 mm in diameter, a commonly used size in practice, plugs of 7 mm in depth showed comparable resistance to pull out and subsidence as 10 mm plugs and significantly better resistance to pull out than 4 mm grafts. PL of allografts prior to insertion did not take away from the structural integrity and stability of the plug.

show abstract

Patellofemoral Arthritis

Frey

Kang

Lin

et al. 2023

Anterior Knee Pain and Patellar Instability

View full text Add to dashboard Cite

Osteochondral Graft Size Is Significantly Associated With Increased Force and Decreased Chondrocyte Viability

Abstract: Based on the current data, graft depth is an important consideration for surgeons when sizing osteochondral allograft transplant for chondral lesions of the knee.

Cited by 8 publications

References 32 publications

An Expert Consensus Statement on the Management of Large Chondral and Osteochondral Defects in the Patellofemoral Joint

An Expert Consensus Statement on the Management of Large Chondral and Osteochondral Defects in the Patellofemoral Joint

Osteochondral Allograft Transplantation: Identifying the Biomechanical Impact of Using Shorter Grafts and Pulsatile Lavage on Graft Stability

Patellofemoral Arthritis

Contact Info

Product

Resources

About