The use of osteochondral allografts in the management of cartilage defects

Abstract

Large symptomatic osteochondral defects in a young active population represent a therapeutic challenge for orthopedic surgeons, since standard interventions such as debridement, microfracture and autologous osteochondral transfer are not suitable for the treatment of these larger lesions. Fresh osteochondral allograft transplantation provides a surgical option for these challenging defects, both as a primary procedure and for salvage of prior failed treatment attempts. This article reviews the basic science, indications, technique, and evidence for osteochondral allograft transplantation in the knee.

Cell-based tissue engineering strategies used in the clinical repair of articular cartilage

“…On the other hand, mosaicplasty with osteochondral auto/allografts has been reported to offer better clinical results than microfracture (14, 15). However, issues with failure at the osseous region, lateral integration, and deterioration of graft edges have contributed to graft failure in 15-55% of patients after 10 years (16-18). Furthermore, mosaicplasty with autografts is limited to treating lesions less than 4 cm 2 to minimize donor site morbidity.…”

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

“…To improve clinical results, osteochondral allograft transplantation can be performed in combination with other procedures such as osteotomy, meniscal allograft transplantation, and ligament reconstruction. 2 Many factors influence the outcome after osteochondral allograft transplantation, which can be related to the patient, to the allograft itself, or to the surgical technique; most of the basic research has been focused on chondrocyte viability and the biomechanical properties of the extracellular matrix of the cartilage and how to preserve their features during the time required for the graft procurement, storage, and testing before release by the tissue bank. In fact, a period of 2 or 3 weeks is usually needed for testing for aerobic, anaerobic, and spore-forming bacteria, as well as viral testing, before release, according the American Association of Tissue Banks/Food and Drug Administration regulatory legislation.…”

Komplexe Gelenkrekonstruktion und Gelenktransplantation mit dem FLOCSAT-Konzept – Planung und chirurgische Umsetzung

“…Mikrofrakturierung (MF), autologe Chondrozytentransplantation (ACT), autologe matrixinduzierte Chondrogenese (AMIC) und andere Therapien sind wichtige Optionen zur Behandlung chondraler Läsionen. Bei großen subchondralen Läsionen, fehlendem intakten Knorpelrand [2,4,7,11,14], gegenüberliegenden ("kissing") Läsio- nen oder großen Knorpel-KnochenDefekten (> 10 cm 2 ) sind sie jedoch weniger geeignet. Die Heilung erfolgt hier über die Bildung eines Faserknorpels, dieser entspricht jedoch histologisch und somit auch biomechanisch nicht dem eines vollwertigen hyalinen Knorpels.…”