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Fresh osteochondral knee allograft

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...
August 5, 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
Guilherme C Gracitelli, Gokhan Meric, Dustin T Briggs, Pamela A Pulido, Julie C McCauley, João Carlos Belloti, William D Bugbee
BACKGROUND: In most treatment algorithms, osteochondral allograft (OCA) transplantation is regarded as an alternative salvage procedure when other, previous reparative treatments have failed. PURPOSE: To compare the outcomes of a retrospective matched-pair cohort of (1) primary OCA transplantation and (2) OCA transplantation after failure of previous subchondral marrow stimulation. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: An OCA database was used to identify 46 knees that had OCA transplantation performed as a primary treatment (group 1) and 46 knees that underwent OCA transplantation after failure of previous subchondral marrow stimulation (group 2)...
April 2015: American Journal of Sports Medicine
Francesca De Caro, Salvatore Bisicchia, Annunziato Amendola, Lei Ding
PURPOSE: The aim of this study was to conduct an updated review of the literature regarding the clinical and basic science knowledge on osteochondral allograft transplantation in the knee for the treatment of large defects. METHODS: According to specific criteria, 2 investigators systematically reviewed the literature for clinical and basic science reports regarding osteochondral allograft transplantation; data were independently extracted, pooled, and analyzed...
April 2015: Arthroscopy: the Journal of Arthroscopic & related Surgery
Guilherme C Gracitelli, Gokhan Meric, Pamela A Pulido, Simon Görtz, Allison J De Young, William D Bugbee
BACKGROUND: The treatment of patellofemoral cartilage injuries can be challenging. Osteochondral allograft (OCA) transplantation has been used as a treatment option for a range of cartilage disorders. PURPOSE: To evaluate functional outcomes and survivorship of the grafts among patients who underwent OCA for patellar cartilage injuries. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: An institutional review board-approved OCA database was used to identify 27 patients (28 knees) who underwent isolated OCA transplantation of the patella between 1983 and 2010...
April 2015: American Journal of Sports Medicine
Gokhan Meric, Guilherme C Gracitelli, Simon Görtz, Allison J De Young, William D Bugbee
BACKGROUND: Osteochondral allograft (OCA) transplantation is an effective treatment option for chondral and osteochondral defects of the knee. HYPOTHESIS: Patients treated with OCAs for reciprocal bipolar lesions of the knee would demonstrate significant clinical improvement. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Between 1983 and 2010, OCAs were implanted for bipolar chondral lesions in 46 patients (48 knees)...
March 2015: American Journal of Sports Medicine
Guy Raz, Oleg A Safir, David J Backstein, Paul T H Lee, Allan E Gross
Osteochondral defects of the knee in young, active patients represent a challenge to the orthopaedic surgeon. Our study examined long-term outcomes of the use of fresh allograft for posttraumatic osteochondral and osteochondritis dissecans defects in the distal aspect of the femur.METHODS: We reviewed the cases of sixty-three patients who underwent osteochondral allograft transplantation to the distal aspect of the femur between 1972 and 1995. Five patients who resided out of the country were lost to follow-up...
July 2, 2014: Journal of Bone and Joint Surgery. American Volume
Geoffrey D Abrams, Kristen E Hussey, Joshua D Harris, Brian J Cole
PURPOSE: To determine clinical results after combined femoral osteochondral allograft and meniscus transplantation. METHODS: Thirty-two patients with a minimum 2-year follow-up were identified who had previously undergone combined meniscus allograft transplantation and fresh osteochondral allograft transplantation. Demographic and intraoperative data, including condylar defect size, as well as the preoperative and postoperative International Knee Documentation Committee (IKDC) score, Short Form 12 score, Knee Injury and Osteoarthritis Outcome Score (KOOS), and Lysholm score, were recorded...
August 2014: Arthroscopy: the Journal of Arthroscopic & related Surgery
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