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Fresh osteochondral allograft

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https://www.readbyqxmd.com/read/29143065/-complex-joint-reconstruction-and-joint-transplantation-with-the-flocsat-concept-planning-and-surgical-implementation
#1
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 cm(2)) 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
#2
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
#3
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
#4
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
#5
Christian Lattermann, Victor Kremser, Burak Altintas
No abstract text is available yet for this article.
October 16, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29018915/-non-cryoconserving-storage-strategies-for-fresh-osteochondral-allografts
#6
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
#7
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...
September 1, 2017: 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
#8
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
#9
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/28937783/validation-of-the-missouri-osteochondral-allograft-preservation-system-for-the-maintenance-of-osteochondral-allograft-quality-during-prolonged-storage
#10
Aaron M Stoker, James P Stannard, Keiichi Kuroki, Chantelle C Bozynski, Ferris M Pfeiffer, James L Cook
BACKGROUND: Fresh osteochondral allografts (OCAs) are limited in availability. The Missouri Osteochondral Allograft Preservation System (MOPS) has been reported to effectively preserve OCAs twice as long as current tissue bank protocols in preclinical studies. HYPOTHESIS: The viable chondrocyte density (VCD) in OCAs preserved for up to 70 days using the MOPS will not be significantly different from day 0, and the VCD in MOPS-preserved OCAs will be significantly higher than for standard tissue bank preservation...
September 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28934881/effectiveness-of-lavage-techniques-in-removing-immunogenic-elements-from-osteochondral-allografts
#11
Maximilian A Meyer, Mark A McCarthy, Matthew E Gitelis, Sarah G Poland, Atsushi Urita, Susan Chubinskaya, Adam B Yanke, Brian J Cole
Objective This study aimed to compare standard saline lavage to combination saline and high-pressure carbon dioxide (CO2) lavage in removing marrow elements from osteochondral allografts. Design Six fresh hemicondyles were obtained. Three osteochondral allograft plugs (15-mm diameter, 6-mm depth) were harvested from each hemicondyle and randomized to 1 of 3 treatment arms: A, no lavage; B, 1 L standard saline lavage; C, simultaneous saline (1 L) and 1-minute high-pressure CO2 lavage. After hematoxylin and eosin staining, a "percentage fill" of remaining marrow elements was calculated for each overall sample and then repeated in 3 distinct compartments for each sample based on depth from surface: 1, deepest third; 2, middle third; and 3, most superficial third...
October 2017: Cartilage
https://www.readbyqxmd.com/read/28737949/effects-of-autogenous-bone-marrow-aspirate-concentrate-on-radiographic-integration-of-femoral-condylar-osteochondral-allografts
#12
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/28706848/bipolar-bone-loss-of-the-shoulder-joint-due-to-recurrent-instability-use-of-fresh-osteochondral-distal-tibia-and-humeral-head-allografts
#13
Daniel B Haber, Anthony Sanchez, George Sanchez, Marcio B Ferrari, Sami Ferdousian, Matthew T Provencher
With increasing shoulder instability events, the likelihood of a bony lesion of the glenoid and/or humeral head rises. Although bone loss of either the glenoid or humeral head may result in recurrent instability, bipolar lesions have been shown, in particular, to result in a negative and additive effect on glenohumeral stability. In the case of a bipolar lesion comprising severe glenoid bone loss and an engaging, "off-track" Hill-Sachs lesion, the bony foundation of the glenohumeral joint is compromised and bony augmentation is necessary...
June 2017: Arthroscopy Techniques
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/28610776/two-stage-late-reconstruction-with-a-fresh-large-osteochondral-shell-allograft-transplantation-flocsat-for-a-large-ostechondral-defect-in-a-non-union-after-a-lateral-tibia-plateau-fracture-2-year-follow-up
#15
C Krettek, J Clausen, M Omar, S Noack, C Neunaber
This is the description of a 58-year-old female patient presenting 8 months after a horse riding accident with significant pain and inability to walk independently. Imaging revealed a large osseous defect of the lateral tibia plateau which was not united posteriorly. The patient refused knee replacement and we developed a patient specific two-step procedure for her. Step 1: Filling of the defect with a large cortico-cancellous autograft from the posterior iliac crest; step 2: Transplantation of a fresh large osteochondral shell allograft (FLOCSAT)...
July 2017: Injury
https://www.readbyqxmd.com/read/28580270/anatomical-glenoid-reconstruction-using-fresh-osteochondral-distal-tibia-allograft-after-failed-latarjet-procedure
#16
Anthony Sanchez, Marcio B Ferrari, Ramesses A Akamefula, Rachel M Frank, George Sanchez, Matthew T Provencher
In the treatment of recurrent anterior glenohumeral instability, the Latarjet procedure has been shown to fail. This results in a need for viable revisional procedures for patients who present with this challenging pathology. We report our preferred technique for anatomical glenoid reconstruction using a fresh osteochondral distal tibia allograft after a failed Latarjet procedure. This bony augmentation technique employs a readily available dense, weight-bearing osseous tissue source that has excellent conformity, as well as the added benefit of a cartilaginous surface to correct chondral deficiencies...
April 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28580254/use-of-a-cutting-instrument-for-fresh-osteochondral-distal-tibia-allograft-preparation-treatment-of-glenoid-bone-loss
#17
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
#18
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
#19
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
#20
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
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