Development of a Fresh Osteochondral Allograft Program Outside North America

Tírico, Luis Eduardo Passarelli; Demange, Marco Kawamura; Santos, Luiz Alberto dos; Rezende, Márcia Uchôa de; Helito, Camilo Partezani; Gobbi, Riccardo Gomes; Pécora, José Ricardo; Croci, Alberto Tesconi; Bugbee, William D.

doi:10.1177/1947603515618484

Cited by 16 publications

(16 citation statements)

References 8 publications

(8 reference statements)

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“…Currently, extensive commercial cell culture therapies, such as autologous chondrocyte transplantation, are not available in the country. 12 The availability of allogeneic transplantation 13 , 14 and collagen membranes is also limited. The instruments for autologous osteochondral transplantation are not available in most centers of the Brazilian Unified Health System.…”

Section: Discussionmentioning

confidence: 99%

Femoral condyle osteochondral fracture treated with bone suture after acute patellar dislocation: a case report

Cavalheiro

Gobbi

Hinckel

et al. 2018

Revista Brasileira de Ortopedia (English Edition)

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Osteochondral fracture after acute patellar dislocation in teenagers is relatively common (up to 60% of cases of patellar dislocation), but poorly diagnosed. There are several treatments proposed for this type of injury, but none well defined in the literature.A male patient, 13 years old, with a diagnosis of osteochondral fracture of the lateral femoral condyle after acute dislocation of the right patella. He underwent surgical treatment of the chondral injury, which consisted of suturing of the chondral fragment to the cartilage defect and, in a second approach, reconstruction of the medial patellotibial ligament and medial patellofemoral ligament with autologous flexor graft. Currently, the patient has been followed up for 16 months postoperatively for the suture of the chondral fragment and for 8 months for the ligament reconstruction. He has been evaluated through functional scores and T2 weighted magnetic resonance imaging. Acute fixation through direct bone suturing of a purely chondral fragment can be considered in special situations.

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Section: Discussionmentioning

confidence: 99%

Femoral condyle osteochondral fracture treated with bone suture after acute patellar dislocation: a case report

Cavalheiro

Gobbi

Hinckel

et al. 2018

Revista Brasileira de Ortopedia (English Edition)

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“…[28][29][30][31][32][33][34][35] These cartilage repair procedures may not be optimal for large cartilage lesions and some are not available to surgeons worldwide. 29,31,34,36 The treatment of small and medium-size chondral lesions was reported by Minzlaff et al 32 on a group of 86 patients who underwent osteochondral autologous transfer combined with valgus HTO. Mean defect size measured intraoperatively 21.5 ± 9.3 mm in diameter.…”

Section: Discussionmentioning

confidence: 99%

Osteochondral Allograft Transplantation and Opening Wedge Tibial Osteotomy: Clinical Results of a Combined Single Procedure

Hsu¹,

Tírico

Lin

et al. 2017

CARTILAGE

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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. The mean graft size was 8.7 cm, with 82% located on the medial femoral condyle alone and 18% involving the medial femoral condyle and one or more other sites. Data collection included demographics, osteotomy correction, graft site(s) and area, and clinical evaluation. Failure was defined as conversion to arthroplasty. Results Two of 17 patients (12%) failed at a mean of 9.3 years. The remaining 15 patients (88%) had intact allografts with mean survival of 8.1 years (SD 3.3). Five patients (29%) had an additional procedure, all undergoing osteotomy hardware removal. Of those with surviving allografts, mean pain and function scores improved significantly from the preoperative to postoperative assessment and International Knee Documentation Committee total scores improved significantly from 40.9 ± 15.4 preoperative to 75.5 ± 24.0 at latest follow-up ( P = 0.003); 92% of patients were satisfied with the results of the surgery. No postoperative complications occurred. Conclusion Combining high tibial osteotomy and OCA in properly selected patients is safe and effective.

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“…A recent example occurred in Brazil, where Dr. Luis Tírico from University of Sao Paulo led a legislative effort to change the law, which succeeded. The process has been documented by Tírico et al 21 and may serve as a template for other countries where legal barriers exist.…”

Section: Regulatorymentioning

confidence: 99%

2016 barriers to cartilage restoration

Farr

Gomoll

2016

Journal of Clinical Orthopaedics and Trauma

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Development of a Fresh Osteochondral Allograft Program Outside North America

Abstract: To our knowledge, this is the first report of fresh osteochondral allograft transplantation in South America. We believe that this experience may be of value for physicians in countries that are trying to establish an osteochondral allograft transplant program.

Cited by 16 publications

References 8 publications

Femoral condyle osteochondral fracture treated with bone suture after acute patellar dislocation: a case report

Femoral condyle osteochondral fracture treated with bone suture after acute patellar dislocation: a case report

Osteochondral Allograft Transplantation and Opening Wedge Tibial Osteotomy: Clinical Results of a Combined Single Procedure

2016 barriers to cartilage restoration

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