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Fresh osteochondral knee allograft

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
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
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
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
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
Dharmpal V Vansadia, James R Heltsley, Scott Montgomery, Misty Suri, Deryk G Jones
BACKGROUND: The risk factors for patellofemoral joint instability include laxity of medial patellar restraints, abnormal limb geometry, femoral and tibial malrotation, patella alta, and trochlear dysplasia. Femoral trochlear dysplasia is characterized by a hypoplastic or shallow trochlear groove. CASE REPORT: We report the case of a 31-year-old female with trochlear dysplasia and recurrent patella dislocations, laxity of the medial patellofemoral ligament (MPFL), and high-grade chondromalacia of the trochlea and the patella...
2016: Ochsner Journal
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...
November 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
Chase S Dean, Jorge Chahla, Raphael Serra Cruz, Robert F LaPrade
Articular cartilage damage of the knee can cause severe morbidity. Owing to its avascular nature, articular cartilage has limited potential for self-healing and increased propensity to progress to osteoarthritis. Treatment of large, full-thickness cartilage defects is still a challenge for orthopaedic surgeons but has recently achieved high success rates with the use of osteochondral allografts. This article details our technique of osteochondral allograft transplantation for the treatment of articular cartilage defects of the knee...
February 2016: Arthroscopy Techniques
Alexander D Cigan, Brendan L Roach, Robert J Nims, Andrea R Tan, Michael B Albro, Aaron M Stoker, James L Cook, Gordana Vunjak-Novakovic, Clark T Hung, Gerard A Ateshian
Animal cells have served as highly controllable model systems for furthering cartilage tissue engineering practices in pursuit of treating osteoarthritis. Although successful strategies for animal cells must ultimately be adapted to human cells to be clinically relevant, human chondrocytes are rarely employed in such studies. In this study, we evaluated the applicability of culture techniques established for juvenile bovine and adult canine chondrocytes to human chondrocytes obtained from fresh or expired osteochondral allografts...
June 14, 2016: Journal of Biomechanics
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
Ioannis C Zouzias, William D Bugbee
The technique of osteochondral allograft (OCA) transplantation has been used to treat a wide spectrum of cartilage deficiencies in the knee. Its use has been supported by basic science and clinical studies that show it is a safe and effective treatment option. What sets fresh OCA transplantation apart from other cartilage procedures in the knee, is the ability to treat large defects with mature hyaline cartilage. Studies looking at transplantation of fresh OCAs in the general population have shown reliable pain relief and return to activities of daily living...
June 2016: Sports Medicine and Arthroscopy Review
Christopher E Gross, Samuel B Adams, Mark E Easley, James A Nunley
Osteochondral lesions of the talus, large or small, are challenging for the treating orthopaedic surgeon. These cartilage and bony defects can cause substantial pain and functional disability. Surgical treatment of small osteochondral lesions of the talus has been thoroughly explored and includes retrograde drilling, arthroscopic débridement and marrow stimulation, osteochondral autografting from cartilage/bone unit harvested from the ipsilateral knee (mosaicplasty), and autologous chondrocyte implantation...
2016: Instructional Course Lectures
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
E W Yates, R A Boden, K Suvarna, I Stockley
No abstract text is available yet for this article.
February 2016: Annals of the Royal College of Surgeons of England
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
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
Alberto Gobbi, Celeste Scotti, John G Lane, Giuseppe M Peretti
The role of fresh allogeneic osteochondral allograft transplantation (OCA) in the cartilage repair algorithm has been long debated and this procedure is primarily considered as a salvage procedure, to be used when other, simple, techniques have failed. Gracitelli et al. in a retrospective comparison of patients who received OCA as primary treatment or as a salvage procedure, demonstrates that the outcome of this procedure is minimally influenced by a previous failed treatment and that OCA represents an effective solution for both primary and revision surgery of chondral and osteochondral lesions of the knee...
July 2015: Annals of Translational Medicine
Karen Chui, Lee Jeys, Martyn Snow
The overall incidence of osteochondral defect in the general population is estimated to be 15 to 30 per 100000 people. These lesions can become symptomatic causing pain, swelling and decreased function of the knee, and may eventually progress to osteoarthritis. In the young and active population, partial or total knee arthroplasty (TKA) is rarely the treatment of choice due to risk of early failure. Osteochondral allograft transplantation has been demonstrated to be a safe and effective treatment of large osteochondral and chondral defects of the knee in appropriately selected patients...
April 18, 2015: World Journal of Orthopedics
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