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Fresh osteochondral grafts

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https://www.readbyqxmd.com/read/29675506/large-osteochondral-allografts-of-the-knee-surgical-technique-and-indications
#1
REVIEW
Gabriele Pisanu, Umberto Cottino, Federica Rosso, Davide Blonna, Antonio Giulio Marmotti, Corrado Bertolo, Roberto Rossi, Davide E Bonasia
Large osteochondral allograft (OCA) transplant has become a valid alternative to restore articular surface in challenging articular lesions in young and active patients, either in primary or in revision procedures. Several studies support the effectiveness and safety of OCA, but costs and graft availability limit their use. The indications are the treatment of symptomatic full-thickness cartilage lesions greater than 3 cm 2 , deep lesions with subchondral damage, or revision procedures when a previous treatment has failed...
March 2018: Joints
https://www.readbyqxmd.com/read/29573913/fresh-osteochondral-allograft-transplantation-for-treatment-of-large-cartilage-defects-of-the-femoral-head-a-minimum-two-year-follow-up-study-of-twenty-two-patients
#2
Xin Y Mei, Ibrahim S Alshaygy, Oleg A Safir, Allan E Gross, Paul R Kuzyk
BACKGROUND: Controversy remains over the surgical management of large osteochondral lesions of the femoral head in young, active patients. The purpose of this study is to assess midterm clinical and radiographic outcomes after fresh osteochondral allograft transplantation (OAT) for large femoral head lesions at minimum 2-year follow-up. METHODS: A retrospective review of prospectively collected data was performed for 22 patients under the age of 50 years with defined femoral head osteochondral lesions who underwent fresh OAT between 2008 and 2015...
February 9, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29570765/effect-of-bisphosphonate-pretreatment-on-fresh-osteochondral-allografts-analysis-of-in-vitro-graft-structure-and-in-vivo-osseous-incorporation
#3
Drew D Moore, Kevin C Baker, Erin A Baker, Mackenzie M Fleischer, Michael D Newton, Nicholas Barreras, Zachary M Vaupel, Paul T Fortin
Fresh allograft transplantation of osteochondral defects restores functional articular cartilage and subchondral bone; however, rapid loss of chondrocyte viability during storage and osteoclast-mediated bone resorption at the graft-host interface after transplantation negatively impact outcomes. The authors present a pilot study evaluating the in vitro and in vivo impact of augmenting storage media with bisphosphonates. Forty cylindrical osteochondral cores were harvested from femoral condyles of human cadaveric specimens and immersed in either standard storage media or storage media supplemented with nitrogenated or non-nitrogenated bisphosphonates...
March 23, 2018: Orthopedics
https://www.readbyqxmd.com/read/29514363/comparison-of-techniques-for-preimplantation-treatment-of-osteochondral-allograft-bone
#4
Charles A Baumann, John R Baumann, Chantelle C Bozynski, Aaron M Stoker, James P Stannard, James L Cook
Articular defects are a major problem with few effective treatment options. Osteochondral allograft (OCA) transplantation can be an effective treatment; however, lack of OCA bone integration can cause failure. This controlled laboratory study was designed to compare clinically applicable methods for marrow element removal and enhanced delivery of bone marrow aspirate concentrate (BMC) to OCA bone. We hypothesized that compressed carbon dioxide (CO2 ) treatment of OCA bone would result in significantly better marrow element removal, significantly more retention and distribution of viable osteoprogenitor cells, and significantly higher osteoinductive protein elution from OCAs compared with other preimplantation treatments...
March 7, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29453700/reliability-of-cartilage-digestion-and-fda-eb-fluorescence-staining-for-the-detection-of-chondrocyte-viability-in-osteochondral-grafts
#5
Jianhong Qi, Famin Cao, Yunning Han, Di Xie, Hongqiang Song, Bin Chen, Lu Zhou
The purpose of this study is to evaluate the reliability of cartilage digestion and fluorescein diacetate-ethidium bromide (FDA-EB) fluorescence staining for the detection of chondrocyte viability in osteochondral grafts. Sixteen fresh osteochondral grafts were harvested from pig knee condyles, and the articular cartilage tissue was preserved. Each cartilage graft was cut into two 70-µm thick pieces and randomly allocated to Group A or Group B. The cell viability of Group A was detected using FDA-EB fluorescence staining of the digested cartilage, and the viability of Group B was detected with FDA-EB fluorescence staining of cartilage sections...
February 16, 2018: Cell and Tissue Banking
https://www.readbyqxmd.com/read/29382209/distal-clavicular-osteochondral-autograft-augmentation-for-glenoid-bone-loss-a-comparison-of-radius-of-restoration-versus-latarjet-graft
#6
Adam Kwapisz, Kelly Fitzpatrick, Jay B Cook, George S Athwal, John M Tokish
BACKGROUND: Bone loss in shoulder instability is a well-recognized cause of failure after stabilization surgery. Many approaches have been described to address glenoid bone loss, including coracoid transfer. This transfer can be technically difficult and has been associated with high complication rates. An ideal alternative to coracoid transfer would be an autologous source of fresh osteochondral graft with enough surface area to replace significant glenoid bone loss. The distal clavicle potentially provides such a graft source that is readily available and low-cost...
April 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29360386/lesion-size-does-not-predict-outcomes-in-fresh-osteochondral-allograft-transplantation
#7
Luis E P Tírico, Julie C McCauley, Pamela A Pulido, William D Bugbee
BACKGROUND: Cartilage repair algorithms use lesion size to choose surgical techniques when selecting a cartilage repair procedure. The association of fresh osteochondral allograft (OCA) size with graft survivorship and subjective patient outcomes is still unknown. PURPOSE: To determine if lesion size (absolute or relative) affects outcomes after OCA transplantation. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: The study included 156 knees in 143 patients who underwent OCA transplantation from 1998 to 2014 for isolated femoral condyle lesions...
March 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29328886/osteochondral-graft-size-is-significantly-associated-with-increased-force-and-decreased-chondrocyte-viability
#8
Brian E Walczak, Matthew S Nies, Darrin J Trask, Scott Hetzel, Patrick J Roney, Matthew W Squire, Geoffrey S Baer
BACKGROUND: Insertion force has been shown to significantly reduce chondrocyte viability during osteochondral allograft transplantation. How graft size influences the required insertion force and chondrocyte viability has yet to be determined. Hypothesis/Purpose: The purpose was to characterize how graft size influences insertion force requirements and chondrocyte viability during osteochondral transplantation. The hypothesis was that larger grafts would require greater force and reduce chondrocyte viability...
March 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29202991/osteochondral-lesions-of-the-talus-treatment-with-fresh-frozen-allograft
#9
Juan Manuel Yañez Arauz, Jorge Javier Del Vecchio, Facundo Bilbao, Nicolas Raimondi
INTRODUCTION: Symptomatic talar osteochondral lesions are about 50% refractory to conservative treatment requiring a surgical solution. In the case of large chronic lesions, the use of bone graft taken from tissue bank is an alternative that enables to fill the defect without causing donor site morbidity. MATERIAL AND METHODS: Eight patients treated with talar osteochondral allograft in lesions greater than 20mm in diameter were analyzed - 4 males and 4 females aging 39...
December 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29138892/-partial-and-complete-joint-transplantation-with-fresh-osteochondral-allografts-the-flocsat-concept
#10
REVIEW
C Krettek, J-D Clausen, N Bruns, C Neunaber
Cartilage defects in adult patients do not heal well. Fresh osteochondral allograft (OCA) transplantation is based on mature, living, mechanically sound hyaline cartilage attached to a bone interface, which is brought into an osteochondral defect, where it becomes osseointegrated. According to current knowledge, intact hyaline cartilage tissue is immune privileged and does not, in contrast to bone, meniscus or ligaments, cause an immune reaction. The technique has the unique advantage of transplanting viable, mature and mechanically stable hyaline cartilage into the affected area...
November 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28970982/concomitant-reverse-hill-sachs-lesion-and-posterior-humeral-avulsion-of-the-glenohumeral-ligament-treatment-with-fresh-talus-osteochondral-allograft-and-arthroscopic-posterior-humeral-avulsion-of-the-glenohumeral-ligament-and-labrum-repair
#11
Justin J Mitchell, Alexander R Vap, George Sanchez, Daniel J Liechti, Jorge Chahla, Gilbert Moatshe, Márcio B Ferrari, Matthew T Provencher
Chronic posterior glenohumeral joint instability can be a challenging clinical entity for patients and surgeons alike. In the setting of a posterior dislocation, a large anterior humeral impaction injury (reverse Hill-Sachs [HS]) may occur, leading to engagement of the humerus with the posterior glenoid bone, especially during internal rotation of the joint. A reverse HS is especially debilitating because of the significant portion of affected humeral head cartilage, and is made worse in the setting of ligamentous disruption such as a posterior humeral avulsion of the glenohumeral ligament (HAGL) lesions...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28956078/-attitude-towards-organ-and-tissue-donation-in-europe-prerequisite-for-osteochondral-allograft-treatment
#12
REVIEW
S Schmidt, A Schulte, S Schwarz, N Hofmann, S Tietz, M Boergel, S U Sixt
BACKGROUND: The biggest obstacle to overcome for routine treatment of various pathologies with fresh osteochondral allograft is the availability of tissue for transplantation. Large fresh osteochondral allografts are usually harvested from organ donors, but in contrast to organs, tissues can be procured after cardiac arrest. OBJECTIVE: Medical staff as well the general public are much less aware of the possibilities and requirements of tissue donation compared to organ donation...
November 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28737949/effects-of-autogenous-bone-marrow-aspirate-concentrate-on-radiographic-integration-of-femoral-condylar-osteochondral-allografts
#13
Lasun O Oladeji, James P Stannard, Cristi R Cook, Mauricio Kfuri, Brett D Crist, Matthew J Smith, James L Cook
BACKGROUND: Transplantation of fresh osteochondral allografts (OCAs) is an attractive treatment option for symptomatic articular cartilage lesions in young, healthy patients. Because the lack of OCA bone integration can be a cause of treatment failure, methods for speeding and enhancing OCA bone integration to mitigate this potential complication are highly desirable. PURPOSE: To determine if autogenous bone marrow aspirate concentrate (BMC) treatment of large femoral condylar OCAs would be associated with superior radiographic OCA bone integration compared with nontreated allografts during the critical first 6 months after surgery...
October 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28618872/outcomes-of-patellofemoral-osteochondral-lesions-treated-with-structural-grafts-in-patients-older-than-40-years
#14
Ryan M Degen, Nathan W Coleman, Danielle Tetreault, Brenda Chang, Greg T Mahony, Christopher L Camp, Shawn G Anthony, Riley J Williams
Background Chondral lesions in the patellofemoral compartment represent a difficult entity to treat among active patients, with no clear consensus on the optimal treatment strategy. The purpose of this study was to review the functional outcomes of patients >40 years old with primary patellofemoral osteochondral lesions who underwent a cartilage restoration procedure with a structural graft. Methods Following institutional review board approval, 35 patients >40 years treated for patellofemoral chondral or osteochondral injuries were retrospectively identified...
July 2017: Cartilage
https://www.readbyqxmd.com/read/28580254/use-of-a-cutting-instrument-for-fresh-osteochondral-distal-tibia-allograft-preparation-treatment-of-glenoid-bone-loss
#15
Marcio B Ferrari, Anthony Sanchez, George Sanchez, Ramesses Akamefula, Bradley M Kruckeberg, Matthew T Provencher
Glenoid bone loss presents a major risk for glenohumeral instability that has been well recognized as a cause of instability recurrence after attempted Bankart repair, and although most surgeons consider the Latarjet procedure as the gold standard, failures can occur with this technique as well and the search for alternative grafts to address glenoid bone loss is a major topic of ongoing research in the field. Of these techniques, the distal tibia allograft (DTA) has been shown to provide an excellent option to restore glenoid biomechanics, due to its congruency with the humeral head, dense bony quality, and the facility of harvest...
April 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28571706/lactated-ringer-based-storage-solutions-are-equally-well-suited-for-the-storage-of-fresh-osteochondral-allografts-as-cell-culture-medium-based-storage-solutions
#16
Afif Harb, Alexander von Horn, Kornelia Gocalek, Luisa Marilena Schäck, Jan Clausen, Christian Krettek, Sandra Noack, Claudia Neunaber
BACKGROUND: Due to the rising interest in Europe to treat large cartilage defects with osteochondrale allografts, research aims to find a suitable solution for long-term storage of osteochondral allografts. This is further encouraged by the fact that legal restrictions currently limit the use of the ingredients from animal or human sources that are being used in other regions of the world (e.g. in the USA). Therefore, the aim of this study was A) to analyze if a Lactated Ringer (LR) based solution is as efficient as a Dulbecco modified Eagle's minimal essential medium (DMEM) in maintaining chondrocyte viability and B) at which storage temperature (4°C vs...
July 2017: Injury
https://www.readbyqxmd.com/read/28551055/fresh-osteochondral-allografts-procurement-and-tissue-donation-in-europe
#17
S Schmidt, A Schulte, S Schwarz, N Hofmann, S Tietz, M Boergel, S U Sixt
Fresh osteochondral allografts are a well-established treatment for large, full-thickness cartilage defects. The clinical outcome for carefully selected patients is very favorable, especially for the young and active and graft survival up to 25 years has been described in the literature. Furthermore, a high patient satisfaction rate has been reported, but the biggest obstacle to overcome is the availability of tissue for transplantation. Large fresh bone allografts for cartilage damage repair only can be harvested from organ donors following organ removal or cadaveric donors, preferably in the setting of an operation room to minimize possible contamination of the tissue...
July 2017: Injury
https://www.readbyqxmd.com/read/28551052/fresh-osteochondral-allotransplants-outcomes-failures-and-future-developments
#18
M Tschon, F Veronesi, S Giannini, M Fini
Osteochondral allografts are used to treat many different conditions as acute traumatic large-sized lesions, degenerative osteoarthritis, osteochondritis dissecans, avascular necrosis or in case of failure of previous procedures particularly in young patients for whom primary prosthesis is not desirable. Fresh allografts present the advantage of having mature viable hyaline cartilage, not causing donor morbidity, allowing the restoration of even large defects in a single surgical session. Conversely, they could account for risks of disease transmission, immunologic reactions, and for limited availability...
July 2017: Injury
https://www.readbyqxmd.com/read/28530850/fresh-osteochondral-allograft-transplantation-is-graft-storage-time-associated-with-clinical-outcomes-and-graft-survivorship
#19
Kenneth J Schmidt, Luís E Tírico, Julie C McCauley, William D Bugbee
BACKGROUND: Regulatory concerns and the popularity of fresh osteochondral allograft (OCA) transplantation have led to a need for prolonged viable storage of osteochondral grafts. Tissue culture media allow a longer storage time but lead to chondrocyte death within the tissue. The long-term clinical consequence of prolonged storage is unknown. HYPOTHESIS: Patients transplanted with OCAs with a shorter storage time would have lower failure rates and better clinical outcomes than those transplanted with OCAs with prolonged storage...
August 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28530120/osteochondral-allograft-transplantation-and-opening-wedge-tibial-osteotomy-clinical-results-of-a-combined-single-procedure
#20
Albert C Hsu, Luis E P Tirico, Abraham G Lin, Pamela A Pulido, William D Bugbee
Objective To evaluate the outcome of patients who have undergone simultaneous osteotomy and osteochondral allograft (OCA) transplantation. Our hypothesis is that use of high tibial osteotomy and fresh OCA in a combined procedure is safe and effective without increasing morbidity in comparison to OCA alone. Design A case series of 17 patients underwent tibial osteotomy and simultaneous OCA during a single surgery. Osteotomy was indicated when axial alignment was within the affected compartment. Patients had a minimum of 2 years of follow-up after surgery...
May 1, 2017: Cartilage
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