Use of Allografts in Orthopaedic Surgery: Safety, Procurement, Storage, and Outcomes

Beer, Adam; Tauro, Tracy; Redondo, Michael L.; Christian, David R.; Cole, Brian J.; Frank, Rachel M.

doi:10.1177/2325967119891435

Cited by 33 publications

(32 citation statements)

References 61 publications

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“…When chondrocytes remain viable during storage, they maintain matrix integrity and, so, the graft properties. 8 Besides, long-term allograft transplant survival depends on graft chondrocyte viability, on matrix maintenance, and on the graft incorporation to host bone. 8,[22][23][24] 4 presents the advantages, disadvantages, and risks of the described technique.…”

Section: Discussionmentioning

confidence: 99%

“…8 Besides, long-term allograft transplant survival depends on graft chondrocyte viability, on matrix maintenance, and on the graft incorporation to host bone. 8,[22][23][24] 4 presents the advantages, disadvantages, and risks of the described technique. On the basis of this report, as described in this protocol, after adequate harvesting, transport, and storage, fresh humeral head osteochondral allograft is an adequate option for the treatment of patients with massive proximal humeral chondral lesions.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 Moreover, there is no consensus in the literature regarding the standardization of a protocol for the harvest, transport, and preservation of humeral osteochondral allografts in tissue banks. 8 So, the goal of this Technical Note is to describe a step-by-step protocol for the harvesting, transport, and preservation of fresh humeral head osteochondral tissue for use in allograft transplantation (Video 1).…”

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confidence: 99%

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Harvest, Transport, and Storage of Fresh Humeral Head Osteochondral Allograft: Step-by-Step Protocol

Petros

Prinz

Rodarte

et al. 2021

Arthroscopy Techniques

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Articular cartilage defects are not common in the glenohumeral joint and are mostly found in patients after shoulder trauma, in patients with recurrent instability, or in patients who underwent previous surgical treatment. Articular cartilage defects lead to pain and loss of motion, consequently causing shoulder function impairment and reducing quality of life. In young patients, the use of osteochondral allografts for the treatment of humeral head defects may avoid well-known complications of shoulder arthroplasty. The goal of this Technical Note is to describe a step-by-step protocol for the harvesting, transport, and preservation of fresh humeral head osteochondral tissue for use in allograft transplantation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Harvest, Transport, and Storage of Fresh Humeral Head Osteochondral Allograft: Step-by-Step Protocol

Petros

Prinz

Rodarte

et al. 2021

Arthroscopy Techniques

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“…A kiterjedt, illetve mély fokális defektusok biológiai kezelésére, a károsodás területén üvegporc minőségű felszín kialakítására az eddigi irodalmi tapasztalatok alapján a homológ porc-csont szöveti transzplantáció, osteochondralis allograft beültetése ad lehetőséget. Az eddigi, zömmel észak-amerikai gyakorlat szövetbanki úton biztosított, 10 napos és 3 hetes kor közötti kivételből származó osteochondralis allograft blokkokat használ [2]. Bár a masszív osteochondralis defektusok kezelésében az említett eljárás kizárólagos biológiai megoldásnak számít, a megfigyelések azt mutatják, hogy az ilyen módon átültetett osteochondralis allograftok hialinporcsejtjei a donáció és a beültetés közt eltelt idő hosszúsága miatt optimális esetben is csak 50%-os túlélést mutatnak [3].…”

Section: Ultrafriss Osteochondralis Allograft Unikompartmentális Károunclassified

Térdporc szegmentálása MR-felvételekből mesterséges intelligencia segítségével

Szoldán¹,

Egyed

Szabó

et al. 2021

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Összefoglaló. Bevezetés: A térdízületnek ultrafriss osteochondralis allograft segítségével történő részleges ortopédiai rekonstrukciója képalkotó vizsgálatokon alapuló pontos tervezést igényel, mely folyamatban a morfológia felismerésére képes mesterséges intelligencia nagy segítséget jelenthet. Célkitűzés: Jelen kutatásunk célja a porc morfológiájának MR-felvételen történő felismerésére alkalmas mesterséges intelligencia kifejlesztése volt. Módszer: A feladatra legalkalmasabb MR-szekvencia meghatározása és 180 térd-MR-felvétel elkészítése után a mesterséges intelligencia tanításához manuálisan és félautomata szegmentálási módszerrel bejelölt porckontúrokkal tréninghalmazt hoztunk létre. A mély convolutiós neuralis hálózaton alapuló mesterséges intelligenciát ezekkel az adatokkal tanítottuk be. Eredmények: Munkánk eredménye, hogy a mesterséges intelligencia képes a meghatározott szekvenciájú MR-felvételen a porcnak a műtéti tervezéshez szükséges pontosságú bejelölésére, mely az első lépés a gép által végzett műtéti tervezés felé. Következtetés: A választott technológia – a mesterséges intelligencia – alkalmasnak tűnik a porc geometriájával kapcsolatos feladatok megoldására, ami széles körű alkalmazási lehetőséget teremt az ízületi terápiában. Orv Hetil. 2021; 162(9): 352–360. Summary. Introduction: The partial orthopedic reconstruction of the knee joint with an osteochondral allograft requires precise planning based on medical imaging reliant; an artificial intelligence capable of determining the morphology of the cartilage tissue can be of great help in such a planning. Objective: We aimed to develop and train an artificial intelligence capable of determining the cartilage morphology in a knee joint based on an MR image. Method: After having determined the most appropriate MR sequence to use for this project and having acquired 180 knee MR images, we created the training set for the artificial intelligence by manually and semi-automatically segmenting the contours of the cartilage in the images. We then trained the neural network with this dataset. Results: As a result of our work, the artificial intelligence is capable to determine the morphology of the cartilage tissue in the MR image to a level of accuracy that is sufficient for surgery planning, therefore we have made the first step towards machine-planned surgeries. Conclusion: The selected technology – artificial intelligence – seems capable of solving tasks related to cartilage geometry, creating a wide range of application opportunities in joint therapy. Orv Hetil. 2021; 162(9): 352–360.

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“…To evaluate the capacity for T-LE Allografts to retain metabolic activity in the presence of a fixation method, an in vitro model was developed to monitor graft tissue outgrowth and metabolism over several time points. First, thin layers of TISSEEL (Baxter, Deerfield, IL, USA) fibrin glue, a standard method of graft fixation in a clinical setting (Supplementary Figure 1A), were placed on the bottoms of a 24-well culture plate followed by promptly placing the tissue graft on the TISSEEL surface and culturing for several week intervals [19]. T-LE Allografts cryopreserved for 2 years at − 80°C and fresh noncryopreserved T-LE Allografts 14 days post date of death (stored at 4°C in media) were utilized to report cellular outgrowth from the graft into the TISSEEL layer in vitro.…”

Section: In Vitro Fixation Outgrowth Assay and Metabolic Testingmentioning

confidence: 99%

Cryopreserved, Thin, Laser-Etched Osteochondral Allograft maintains the functional components of articular cartilage after 2 years of storage

et al. 2020

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Background Despite improvements in treatment options and techniques, articular cartilage repair continues to be a challenge for orthopedic surgeons. This study provides data to support that the 2-year Cryopreserved, Thin, Laser-Etched Osteochondral Allograft (T-LE Allograft) embodies the necessary viable cells, protein signaling, and extracellular matrix (ECM) scaffold found in fresh cartilage in order to facilitate a positive clinical outcome for cartilage defect replacement and repair. Methods Viability testing was performed by digestion of the graft, and cells were counted using a trypan blue assay. Growth factor and ECM protein content was quantified using biochemical assays. A fixation model was introduced to assess tissue outgrowth capability and cellular metabolic activity in vitro. Histological and immunofluorescence staining were employed to confirm tissue architecture, cellular outgrowth, and presence of ECM. The effects of the T-LE Allograft to signal bone marrow-derived mesenchymal stem cell (BM-MSC) migration and chondrogenic differentiation were evaluated using in vitro co-culture assays. Immunogenicity testing was completed using flow cytometry analysis of cells obtained from digested T-LE Allografts and fresh articular cartilage. Results Average viability of the T-LE Allograft post-thaw was found to be 94.97 ± 3.38%, compared to 98.83 ± 0.43% for fresh articular cartilage. Explant studies from the in vitro fixation model confirmed the long-term viability and proliferative capacity of these chondrocytes. Growth factor and ECM proteins were quantified for the T-LE Allograft revealing similar profiles to fresh articular cartilage. Cellular signaling of the T-LE Allograft and fresh articular cartilage both exhibited similar outcomes in co-culture for migration and differentiation of BM-MSCs. Flow cytometry testing confirmed the T-LE Allograft is immune-privileged as it is negative for immunogenic markers and positive for chondrogenic markers. Conclusions Using our novel, proprietary cryopreservation method, the T-LE Allograft, retains excellent cellular viability, with native-like growth factor and ECM composition of healthy cartilage after 2 years of storage at − 80 °C. The successful cryopreservation of the T-LE Allograft alleviates the limited availably of conventionally used fresh osteochondral allograft (OCA), by providing a readily available and simple to use allograft solution. The results presented in this paper supports clinical data that the T-LE Allograft can be a successful option for repairing chondral defects.

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Use of Allografts in Orthopaedic Surgery: Safety, Procurement, Storage, and Outcomes

Cited by 33 publications

References 61 publications

Harvest, Transport, and Storage of Fresh Humeral Head Osteochondral Allograft: Step-by-Step Protocol

Harvest, Transport, and Storage of Fresh Humeral Head Osteochondral Allograft: Step-by-Step Protocol

Térdporc szegmentálása MR-felvételekből mesterséges intelligencia segítségével

Cryopreserved, Thin, Laser-Etched Osteochondral Allograft maintains the functional components of articular cartilage after 2 years of storage

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