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Fresh osteochondral allograft

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https://www.readbyqxmd.com/read/28737949/effects-of-autogenous-bone-marrow-aspirate-concentrate-on-radiographic-integration-of-femoral-condylar-osteochondral-allografts
#1
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...
July 1, 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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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...
May 11, 2017: Injury
https://www.readbyqxmd.com/read/28551052/fresh-osteochondral-allotransplants-outcomes-failures-and-future-developments
#9
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...
May 11, 2017: Injury
https://www.readbyqxmd.com/read/28530850/fresh-osteochondral-allograft-transplantation-is-graft-storage-time-associated-with-clinical-outcomes-and-graft-survivorship
#10
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
#11
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
https://www.readbyqxmd.com/read/28529013/bipolar-fresh-total-osteochondral-allograft-in-the-ankle-is-it-a-successful-long-term-solution
#12
S Giannini, A Mazzotti, F Vannini
INTRODUCTION: Severe post-traumatic ankle arthritis poses a reconstructive challenge in young and active patients. Although technically demanding and despite unsolved immunological issues, bipolar fresh total osteochondral allograft (BFTOA) represent an intriguing option to arthrodesis and prosthetic replacement. The purpose of this paper is to evaluate the outcomes of a series of 48 ankle BFTOA at 10 years follow up and to investigate the rate of survival long term. METHODS: 58 patients underwent BFTOA, of these 48 were available for follow up...
May 11, 2017: Injury
https://www.readbyqxmd.com/read/28464040/pulsed-lavage-cleansing-of-osteochondral-grafts-depends-on-lavage-duration-flow-intensity-and-graft-storage-condition
#13
Yang Sun, Weibo Jiang, Esther Cory, Jason P Caffrey, Felix H Hsu, Albert C Chen, Jincheng Wang, Robert L Sah, William D Bugbee
INTRODUCTION: Osteochondral allograft (OCA) transplantation is generally effective for treating large cartilage lesions. Cleansing OCA subchondral bone to remove donor marrow elements is typically performed with pulsed lavage. However, the effects of clinical and experimental parameters on OCA marrow removal by pulsed lavage are unknown. The aim of the current study was to determine the effects on marrow cleansing in human osteochondral cores (OCs) of (1) lavage duration, (2) lavage flow intensity, and (3) OC sample type and storage condition...
2017: PloS One
https://www.readbyqxmd.com/read/28418278/the-effect-of-surgical-insertion-and-proinflammatory-cytokines-on-osteochondral-allograft-survival-and-metabolism
#14
Samantha L Gitelis, Ariel Bodker, Michel P Laurent, Spencer S Kirk, Giuseppe Filardo, Maximilian A Meyer, Arnavaz A Hakimiyan, Lev Rappoport, Markus A Wimmer, Brian J Cole, Susan Chubinskaya
Objective To investigate the responses of refrigerated osteochondral allograft cartilage (OCA) and fresh cartilage (FC), including cell survival and metabolism, to surgical impaction and proinflammatory cytokines. Design Osteochondral plugs (8 mm diameter) were harvested from prolonged-refrigerated (14-28 days) and fresh (≤24 hours postmortem) human femoral hemicondyles and subjected to a 0.2 N s pneumatic impaction impulse. Cartilage explants were removed from subchondral bone and randomized to 1 of 6 treatment groups: (1) Unimpacted control (UIC), (2) Impacted control (IC), (3) Impacted + interleukin (IL)-1β (0...
January 1, 2017: Cartilage
https://www.readbyqxmd.com/read/28409110/anatomic-humeral-head-reconstruction-with-fresh-osteochondral-talus-allograft-for-recurrent-glenohumeral-instability-with-reverse-hill-sachs-lesion
#15
Matthew T Provencher, George Sanchez, Katrina Schantz, Marcio Ferrari, Anthony Sanchez, Salvatore Frangiamore, Sandeep Mannava
The treatment of recurrent glenohumeral instability, especially with a concomitant bony lesion, remains challenging. This is especially true in the case of posterior instability given its less common incidence. Moreover, the presence of an engaging reverse Hill-Sachs lesion in combination with posterior instability will result in the need for a more aggressive treatment option. In comparison with a Hill-Sachs lesion, a reverse Hill-Sachs lesion features greater chondral deficiency that must be addressed during treatment...
February 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28406876/cartilage-restoration-techniques-for-the-patellofemoral-joint
#16
Robert H Brophy, Robert D Wojahn, Joseph D Lamplot
Symptomatic osteochondral lesions of the patellofemoral joint are clinically challenging to manage because of the limited healing potential of articular cartilage; the complex morphology of the patellofemoral joint; the heterogeneity of the articular surface between patients; and high stresses across the joint, which can be altered by malalignment, tilt, or maltracking. Indications for surgery include traumatic lesions, osteochondritis dissecans, and high-grade chondromalacia in association with persistent pain despite a course of nonsurgical management...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28385038/review-of-mechanical-processing-and-immunologic-factors-associated-with-outcomes-of-fresh-osteochondral-allograft-transplantation-of-the-talus
#17
Chikezie N Okeagu, Erin A Baker, Nicholas A Barreras, Zachary M Vaupel, Paul T Fortin, Kevin C Baker
Osteochondral lesions of the talus (OLTs) are an increasingly implicated cause of ankle pain and instability. Several treatment methods exist with varying clinical outcomes. Due in part to successful osteochondral allografting (OCA) in other joints, such as the knee and shoulder, OCA has gained popularity as a treatment option, especially in the setting of large lesions. The clinical outcomes of talar OCA have been inconsistent relative to the positive results observed in other joints. Current literature regarding OCA failure focuses mainly on 3 factors: the effect of graft storage conditions on chondrocyte viability, graft/lesion size, and operative technique...
April 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28345414/fresh-osteochondral-allograft-transplantation-for-fractures-of-the-knee
#18
Guilherme C Gracitelli, Luis Eduardo Passarelli Tirico, Julie C McCauley, Pamela A Pulido, William D Bugbee
Objective The purpose of this study was to evaluate functional outcomes and allograft survivorship among patients with knee fracture who underwent fresh osteochondral allograft (OCA) transplantation as a salvage treatment option. Design Retrospective analysis of prospectively collected data. Setting Department of Orthopaedic Surgery at one hospital. Patients Fresh OCAs were implanted for osteochondral lesions after knee fracture in 24 males and 15 females with an average age of 34 years. Twenty-nine lesions (74%) were tibial plateau fractures, 6 (15%) were femoral condyle fractures, and 4 (10%) were patella fractures...
April 2017: Cartilage
https://www.readbyqxmd.com/read/28196392/patellofemoral-osteochondral-allografts-can-we-improve-the-matching-process
#19
Jason R Determann, James E Fleischli, Donald F D'Alessandro, Dana P Piasecki
An important consideration for the successful use of fresh osteochondral allografts for the patellofemoral joint is selection of appropriately sized donor allografts. This is particularly challenging for matching grafts to the patella because of the substantial variability in articular contour that exists. At present, selection of donor patellae is based only on the width of the proximal tibia, with no established means of quantifying basic patellar size, facet configuration, or articular contour. We hypothesized that using a combination of standard radiographic measurements to generate an accurate profile of the recipients native patella would result in a more accurate donor graft...
February 14, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28194385/fresh-osteochondral-knee-allografts-in-brazil-with-a-minimum-two-year-follow-up
#20
Luís Eduardo Passarelli Tírico, Marco Kawamura Demange, Luiz Augusto Ubirajara Santos, José Ricardo Pécora, Alberto Tesconi Croci, Gilberto Luís Camanho
OBJECTIVE: The present study aimed to report the results of the first series of cases of fresh ostechondral allografts in the knee joint in Brazil with a minimum follow-up of two years. METHODS: A protocol of procurement, harvesting, processing, and utilization of fresh osteochondral allografts in the knee joint was established, beginning with legislation modifications, graft harvesting techniques, immediate processing, storage of fresh grafts, and utilization of two surgical techniques of osteochondral transplantation...
January 2017: Revista Brasileira de Ortopedia
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