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Fresh osteochondral allograft

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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/29577591/effects-of-antigen-removal-on-a-porcine-osteochondral-xenograft-for-articular-cartilage-repair
#2
Steve Elder, Hudson Chenault, Paul Gloth, Katie Webb, Ruth Recinos, Emily Wright, Dalton Moran, James Butler, Abdolsamad Borazjani, Avery Cooley
Given the limited availability of fresh osteochondral allografts and uncertainty regarding performance of decellularized allografts, this study was undertaken as part of an effort to develop an osteochondral xenograft for articular cartilage repair. The purpose was to evaluate a simple antigen removal procedure based mainly on treatment with SDS and nucleases. Histology demonstrated a preservation of collagenous structure and removal of most nuclei. Immunohistochemistry revealed the apparent retention of α-Gal within osteocyte lacunae unless the tissue underwent an additional α-galactosidase processing step...
March 25, 2018: Journal of Biomedical Materials Research. Part A
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
#3
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
#4
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
#5
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/29360386/lesion-size-does-not-predict-outcomes-in-fresh-osteochondral-allograft-transplantation
#6
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/29354455/fresh-osteochondral-allograft-transplantation-for-focal-chondral-defect-of-the-humerus-associated-with-anchor-arthropathy-and-failed-slap-repair
#7
Kevin C Wang, Brian R Waterman, Eric J Cotter, Rachel M Frank, Brian J Cole
Isolated, full-thickness articular cartilage lesions of the glenohumeral joint can cause pain, mechanical symptoms, and impaired function. Reports on operative management of these injuries with arthroscopic techniques, such as marrow stimulation, have shown improvement in patient symptoms. In cases where the subchondral bone is involved, osteochondral allograft (OCA) transplantation has shown positive results for contained, focal cartilage defects. The technique for OCA transplantation to treat Hill-Sachs lesions has been reported in detail, and there are multiple case series reporting on the outcomes of OCA used for this purpose...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29354446/multiple-osteochondral-allograft-transplantation-with-concomitant-tibial-tubercle-osteotomy-for-multifocal-chondral-disease-of-the-knee
#8
Eric J Cotter, Brian R Waterman, Mick P Kelly, Kevin C Wang, Rachel M Frank, Brian J Cole
Symptomatic patellofemoral chondral lesions are a challenging clinical entity, as these defects may result from persistent lateral patellar maltracking or repetitive microtrauma. Anteromedializing tibial tubercle osteotomy has been shown to be an effective strategy for primary and adjunctive treatment of focal or diffuse patellofemoral disease to improve the biomechanical loading environment. Similarly, osteochondral allograft transplantation has proven efficacy in physiologically young, high-demand patients with condylar or patellofemoral lesions, particularly without early arthritic progression...
August 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29328886/osteochondral-graft-size-is-significantly-associated-with-increased-force-and-decreased-chondrocyte-viability
#9
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
#10
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/29198358/editorial-commentary-the-acellular-osteochondral-allograft-the-emperor-has-new-clothes
#11
EDITORIAL
Bert R Mandelbaum, Jorge Chahla
For larger lesions (>2.5-cm2 ), clinical evidence and practice have shown that fresh osteochondral allograft have good durability, with 88% return to sport and greater than 75% 10-year survival rates for treatment of large femoral condyle lesions. That said, the use of fresh osteochondral allografts in clinical practice is limited by the availability of acceptable donor tissues for eligible patients in a timely fashion. Significant diminution of chondrocyte viability and density occurs during the preservation and storage period...
December 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29143065/-complex-joint-reconstruction-and-joint-transplantation-with-the-flocsat-concept-planning-and-surgical-implementation
#12
REVIEW
C Krettek, J-D Clausen, C Neunaber
Cartilage defects in adult patients are so far incurable. Fresh osteochondral allograft (OCA) transplantation is based on the insertion of mature, living, mechanically sound hyaline cartilage into an osteochondral defect where it undergoes osseointegration. Intact hyaline cartilage of OCA does not cause immune reactions in the recipient. Many reports show that small OCA have good osseointegration and show good long-term results. These observations have been incorporated into the development of the fresh large (> 10 cm2 ) osteochondral shell allograft transplantation (FLOCSAT) concept, which is based on the following principles: 1) the thickness of the osseous layer should be kept as thin as possible (target < 6-8 mm) so that the transplant remains stable and fixable...
November 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/29138892/-partial-and-complete-joint-transplantation-with-fresh-osteochondral-allografts-the-flocsat-concept
#13
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/29051901/fresh-osteochondral-allograft-transplantation-for-spontaneous-osteonecrosis-of-the-knee-a-case-series
#14
Luís E P Tírico, Samuel A Early, Julie C McCauley, William D Bugbee
BACKGROUND: Spontaneous osteonecrosis of the knee (SONK) is a clinical entity identified by acute knee pain usually associated with joint effusion, with radiographic findings of a radiolucent defect on the weightbearing area of the femoral condyle. Conservative treatment is initially undertaken; however, surgical procedures are often necessary. Historically, surgical options have included core decompression, cartilage repair, high tibial osteotomy, or joint arthroplasty. Few studies in the literature have reported the use of fresh osteochondral allograft (OCA) for the treatment of SONK lesions...
October 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29048690/large-fresh-osteochondral-allografts-for-the-hip-growing-the-evidence
#15
Lasun O Oladeji, James L Cook, James P Stannard, Brett D Crist
INTRODUCTION: Articular cartilage lesions of the hip are difficult to effectively treat. Osteochondral allograft (OCA) transplantation in the knee has been associated with long-term success, but OCA for the hip has not been extensively studied. Here, we present the clinical and radiological outcomes from a cohort of 10 patients treated with fresh OCA transplants for large osteochondral defects of the femoral head and/or acetabulum. METHODS: 10 patients who had undergone osteochondral allograft transplantation of the femoral head and/or acetabulum at our institution between 2013 and 2016 were identified from our Institutional Review Board-approved registry...
October 17, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29036755/use-of-fresh-osteochondral-allografts-in-the-patellofemoral-joint
#16
Christian Lattermann, Victor Kremser, Burak Altintas
Fresh osteochondral allograft (OCA) transplantation has become a mainstay for the treatment of osteochondral defects in the tibiofemoral joint. With excellent outcomes and high survival times, this technology has recently become more interesting for use in the patellofemoral (PF) joint. This review article will point out the historical difficulties that the use of fresh OCA poses. With newer surgical approaches and a better understanding of the mechanical requirements of the PF joint, the use of OCA transplantation has shown increasingly better results...
March 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29018915/-non-cryoconserving-storage-strategies-for-fresh-osteochondral-allografts
#17
REVIEW
Luisa Marilena Schäck, Jan-Dierk Clausen, Sandra Noack, Afif Harb, Christian Krettek, Claudia Neunaber
BACKGROUND: The clinical outcome of fresh allogeneic osteochondral allografts (OCA) is greatly dependent on the number of viable chondrocytes at the time of implantation. The selection and preparation of a suitable recipient can be very time-consuming and the number of tissue donors is greatly limited; therefore, the preservation of high allograft viability before transplantation is a focal point of current research. OBJECTIVE: The objective of this review is to give an overview of established storage strategies for OCA and to serve as a decision-making aid for German clinics in the choice of a suitable storage strategy...
November 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28971693/prospective-evaluation-of-structural-allograft-transplantation-for-osteochondral-lesions-of-the-talar-shoulder
#18
Samuel B Adams, Travis J Dekker, Adam P Schiff, Christopher P Gross, James A Nunley, Mark E Easley
BACKGROUND: Structural or bulk osteochondral allograft transplantation for shoulder talar osteochondral lesions as a salvage procedure has demonstrated efficacy in several retrospective reviews. The purpose of this study was to evaluate prospectively patients who received fresh structural allograft transplantation to the talus. METHODS: Prospective evaluation of a consecutive series of patients who underwent fresh structural allograft transplantation for an osteochondral lesion of the talus (OLT) was performed...
January 2018: Foot & Ankle International
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
#19
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
#20
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
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