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Fresh osteochondral grafts

Kadir Buyukdogan, Mahmut Nedim Doral, Onur Bilge, Egemen Turhan, Gazi Huri, Mustafa Fevzi Sargon
OBJECTIVE: The purpose of this study was to investigate the effects of the omentum, peritoneum, paratenon and skeletal muscle on the proliferation of the cartilage tissue using rabbit model as an in vivo culture medium. METHODS: 6 months old forty-five New Zealand rabbits were randomized into omentum, peritoneum, muscle, and Achilles paratenon groups. Standard sized osteochondral grafts were harvested from right knees and immediately placed into the specified tissues...
October 4, 2016: Acta Orthopaedica et Traumatologica Turcica
Justin D Orr, John C Dunn, Kenneth A Heida, Nicholas A Kusnezov, Brian R Waterman, Philip J Belmont
INTRODUCTION: Structural fresh osteochondral allograft transfer is an appropriate treatment option for large osteochondral lesions of the talus (OLTs), specifically lesions involving the shoulder of the talus. Sparse literature exists regarding functional outcome following this surgery in high-demand populations. MATERIALS AND METHODS: Over a 2-year period, a single surgeon performed 8 structural allograft transfers for treatment of large OLTs in an active duty US military population...
September 13, 2016: Foot & Ankle Specialist
Richard J VanTienderen, John C Dunn, Nicholas Kusnezov, Justin D Orr
PURPOSE: The purpose of this study is to present a systematic review of the literature regarding the use of fresh bulk osteochondral allograft transfer for treatment of large osteochondral lesions of the talus (OCLT) in an effort to characterize the functional outcomes, complications, and reoperation rates. METHODS: A search of the PubMed, CINAHL, Embase, and Cochrane Databases was performed between January 1, 1990, and March 1, 2016, and included all articles related to outcomes after fresh talar allograft transplantation for OCLT...
August 18, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Kamran N Sadr, Pamela A Pulido, Julie C McCauley, William D Bugbee
BACKGROUND: Osteochondritis dissecans (OCD) of the knee can be difficult to treat. Cartilage restoration techniques are often indicated when the lesion or fragment cannot be salvaged and the patient remains symptomatic. Fresh osteochondral allograft (OCA) transplantation can restore both bone and cartilage defects characteristic of OCD. HYPOTHESIS: We hypothesized that osteochondral allografting is a successful method for treating OCD of the knee. STUDY DESIGN: Case series; Level of evidence, 4...
August 5, 2016: American Journal of Sports Medicine
Luís Eduardo Passarelli Tírico, Marco Kawamura Demange, Luiz Augusto Ubirajara Santos, Márcia Uchoa de Rezende, Camilo Partezani Helito, Riccardo Gomes Gobbi, José Ricardo Pécora, Alberto Tesconi Croci, William Dick Bugbee
OBJECTIVE: To standardize and to develop a fresh osteochondral allograft protocol of procurement, processing and surgical utilization in Brazil. This study describes the steps recommended to make fresh osteochondral allografts a viable treatment option in a country without previous fresh allograft availability. DESIGN: The process involves regulatory process modification, developing and establishing procurement, and processing and surgical protocols. RESULTS: Legislation: Fresh osteochondral allografts were not feasible in Brazil until 2009 because the law prohibited preservation of fresh grafts at tissue banks...
July 2016: Cartilage
Eric C McCarty, Ryan R Fader, Justin J Mitchell, R Edward Glenn, Hollis G Potter, Kurt P Spindler
BACKGROUND: Osteochondral autografts and allografts have been widely used in the treatment of isolated grade 4 articular cartilage lesions of the knee. However, there is a paucity of literature regarding the basic science investigating the direct comparison between fresh osteochondral allografts to autografts. HYPOTHESIS: At 12 months, fresh osteochondral allografts are equal to autografts with respect to function, bony incorporation into host bone, and chondrocyte viability...
September 2016: American Journal of Sports Medicine
Ryan Joseph Pomajzl, Erin Ann Baker, Kevin Charles Baker, Mackenzie Marie Fleischer, Meagan R Salisbury, Dylan M Phillips, Paul Thomas Fortin
BACKGROUND: Fresh osteochondral allografting of the talus is one treatment option for large chondral defects. Following positive early term results, failure rates of up to 35% have been reported. A retrieval study was performed to characterize failed talar allografts. METHODS: Failed fresh osteochondral allografts of the talus were retrieved on revision. Cases of deep infection were excluded. After tissue fixation, samples were decalcified, embedded, and stained with Safranin-O/Fast Green, osteocalcin, tumor necrosis factor alpha (TNF-α), CD4, CD8, and CD68...
September 2016: Foot & Ankle International
Jack Farr, Guilherme C Gracitelli, Nehal Shah, Eric Y Chang, Andreas H Gomoll
BACKGROUND: Widespread adoption of fresh allograft transplantation remains limited, predominantly by supply issues. To overcome these limitations, a preshaped, cylindrical sterilized and decellularized osteochondral allograft (SDOCA) implant was recently introduced as a clinical treatment option. PURPOSE: To evaluate functional outcomes and graft survivorship among patients treated with the SDOCA implant for knee cartilage injuries. STUDY DESIGN: Case series; Level of evidence, 4...
August 2016: American Journal of Sports Medicine
Erik Hohmann, Kevin Tetsworth
BACKGROUND: The purpose of this study was to review the clinical results of irradiated fresh frozen osteochondral allografts for large osteochondral defects of the knee using the Mega-OATS technique. METHODS: Nine patients with a mean age of 32.1±6.6 (18 to 44) underwent Mega-OATS transplantation with irradiated (2.5Mrad), fresh frozen distal femur allograft. Three patients also underwent ACL-reconstruction; one patient a high tibial osteotomy. The underlying indication was osteochondrosis dissecans in four and trauma in five patients...
June 2016: Knee
Abdulaziz Z Alomar, Ali Mohammed Somily, Thamer M Alraiyes, Ahmad S Bin Nasser, Fawzi F Aljassir
BACKGROUND: Inadvertent contamination of osteochondral (OC) autografts during harvesting and preparation can lead to significant complications and can cause the operating team to weigh the infection risk after reimplantation against discarding the OC fragment. The most commonly reported contamination mechanism is the accidental dropping of an OC fragment; however, associated contamination levels remain unclear. The rate and level of contamination during standard harvesting and preparation are also unknown...
March 2016: American Journal of Sports Medicine
James I Cameron, Pamela A Pulido, Julie C McCauley, William D Bugbee
BACKGROUND: Osteochondral allograft (OCA) transplantation is a recognized treatment modality for cartilage damage in the knee. Few reports are available on outcomes of OCA in the patellofemoral joint, and there are no reports on lesions isolated to the femoral trochlea. PURPOSE: To evaluate graft survivorship and clinical outcomes in patients who had an OCA to the femoral trochlea. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: An OCA database was used to identify 29 knees in 28 patients (mean age, 30...
March 2016: American Journal of Sports Medicine
Jamal Ahmad, Kennis Jones
BACKGROUND: The purpose of this study was to prospectively evaluate and compare the long-term clinical and radiographic outcomes of using osteochondral autograft and allograft to manage either recurrent or large osteochondral lesions of the talar dome (OLT) in a single surgeon's practice. METHODS: Between January 2008 and January 2014, a total of 40 patients presented with either a recurrent OLT that failed initial arthroscopic treatment (ie, excision, curettage, debridement, and micro-fracture) or a primary OLT greater than 1...
January 2016: Foot & Ankle International
Siming Li, Xiaohong Yang, Shenghui Tang, Xunmeng Zhang, Zhencheng Feng, Shuliang Cui
Surgical replacement of massively defected joints necessarily relies on osteochondral grafts effective to both of bone and cartilage. Demineralized bone matrix (DBM) retains the osteoconductivity but destroys viable chondrocytes in the cartilage portion essential for successful restoration of defected joints. This study prepared osteochondral grafts of DBM with protected cartilage. Protected cartilage portions was characterized by cellular and molecular biology and the grafts were allogenically used for grafting...
August 2015: Journal of Materials Science. Materials in Medicine
Lei Ding, Biagio Zampogna, Sebastiano Vasta, Kee Woong Jang, Francesca De Caro, James A Martin, Annunziato Amendola
BACKGROUND: Transplantation of osteochondral allografts (OCAs) freshly preserved for ≥30 days has proven to be a reliable technique for cartilage resurfacing. However, the prolonged storage of allografts comes at the expense of chondrocyte viability, which declines precipitously after 14 days under refrigeration. Despite this, radiographic data indicate that most allograft cartilage remains stable for years after implantation. The apparent durability of partially devitalized cartilage begs the question of how the extracellular matrix is maintained...
October 2015: American Journal of Sports Medicine
Stephanie M Gancarczyk, Eric C Makhni, Joseph M Lombardi, Charles A Popkin, Christopher S Ahmad
BACKGROUND: Articular reconstruction is recommended for some unstable capitellar osteochondritis dissecans (OCD) lesions. Capitellar osteochondral autograft transplantation (OAT) through an open approach for optimal visualization and perpendicular graft implantation has been advocated. However, arthroscopic capitellar OAT may achieve the same treatment goals with decreased morbidity and ability to treat the entire joint for pathologic changes. PURPOSE/HYPOTHESIS: The purpose of this study was to assess the ability to resurface the capitellum arthroscopically...
October 2015: American Journal of Sports Medicine
Takuya Yamada, Kentaro Uchida, Kenji Onuma, Gen Inoue, Jun Aikawa, Shotaro Takano, Hiroyuki Sekiguchi, Hisako Fujimaki, Masayuki Miyagi, Masashi Takaso
Osteochondral allografting is a promising option for the treatment of large cartilage defects. However, because the cell viability of osteochondral tissues (OCTs) gradually reduces during storage at 4°C, methods for maintaining the cell viability of fresh OCTs are needed to improve transplantation outcomes. Here, we evaluated whether the supplementation of preservation solution with one of three different molecular weight forms of hyaluronic acid (HA) improved the viability of rat OCTs during long-term cold storage...
2015: TheScientificWorldJournal
Bryan M Saltzman, Jonathan C Riboh, Brian J Cole, Adam B Yanke
PURPOSE: To synthesize, in a systematic review, the available clinical evidence of osteochondral allograft transplants for large osteochondral defects of the humeral head. METHODS: The Medline, Embase, and Cochrane databases were searched for studies reporting clinical or radiographic outcomes of osteochondral allograft transplantation for humeral head defects. Descriptive statistics were provided for all outcomes. After checking for data normality, we compared postoperative and preoperative values using the Student t test...
September 2015: Arthroscopy: the Journal of Arthroscopic & related Surgery
Guilherme C Gracitelli, Gokhan Meric, Dustin T Briggs, Pamela A Pulido, Julie C McCauley, João Carlos Belloti, William D Bugbee
BACKGROUND: In most treatment algorithms, osteochondral allograft (OCA) transplantation is regarded as an alternative salvage procedure when other, previous reparative treatments have failed. PURPOSE: To compare the outcomes of a retrospective matched-pair cohort of (1) primary OCA transplantation and (2) OCA transplantation after failure of previous subchondral marrow stimulation. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: An OCA database was used to identify 46 knees that had OCA transplantation performed as a primary treatment (group 1) and 46 knees that underwent OCA transplantation after failure of previous subchondral marrow stimulation (group 2)...
April 2015: American Journal of Sports Medicine
Francesca De Caro, Salvatore Bisicchia, Annunziato Amendola, Lei Ding
PURPOSE: The aim of this study was to conduct an updated review of the literature regarding the clinical and basic science knowledge on osteochondral allograft transplantation in the knee for the treatment of large defects. METHODS: According to specific criteria, 2 investigators systematically reviewed the literature for clinical and basic science reports regarding osteochondral allograft transplantation; data were independently extracted, pooled, and analyzed...
April 2015: Arthroscopy: the Journal of Arthroscopic & related Surgery
Guilherme C Gracitelli, Gokhan Meric, Pamela A Pulido, Simon Görtz, Allison J De Young, William D Bugbee
BACKGROUND: The treatment of patellofemoral cartilage injuries can be challenging. Osteochondral allograft (OCA) transplantation has been used as a treatment option for a range of cartilage disorders. PURPOSE: To evaluate functional outcomes and survivorship of the grafts among patients who underwent OCA for patellar cartilage injuries. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: An institutional review board-approved OCA database was used to identify 27 patients (28 knees) who underwent isolated OCA transplantation of the patella between 1983 and 2010...
April 2015: American Journal of Sports Medicine
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