Fresh Osteochondral Allografts for Post-Traumatic Osteochondral Defects of the Knee

Ghazavi, Mohammad; Pritzker, Kenneth P.H.; Davis, Aileen M.; Gross, Allan E.

doi:10.1302/0301-620x.79b6.0791008

Cited by 198 publications

(135 citation statements)

References 18 publications

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“…Logistic regression was used to evaluate factors associated with potentially better survival, such as age at the time of surgery and side of the transplant (medial or lateral). Where realignment osteotomy for unloading the graft has been shown to have superior results, this factor was not evaluated again, nor was sex of the patient, which had no impact on results previously 8,17,25 . Radiographic outcome was evaluated at least ten years from the time of surgery.…”

Section: Outcome Measuresmentioning

confidence: 99%

Distal Femoral Fresh Osteochondral Allografts

Raz¹,

Safir

Backstein

et al. 2014

The Journal of Bone and Joint Surgery

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Section: Outcome Measuresmentioning

confidence: 99%

Distal Femoral Fresh Osteochondral Allografts

Raz¹,

Safir

Backstein

et al. 2014

The Journal of Bone and Joint Surgery

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“…Discussion O steochondral allografts are widely used to treat cartilage lesions. They have a long track record of success [8][9][10][11] . Currently, they are particularly suited for use in large cartilage defects or those that involve the subchondral bone.…”

Section: Chondrogenic Capacitymentioning

confidence: 99%

Chondrogenic Potential and Homogeneity of Cell Populations of Donor and Recipient Cells in a Fresh Osteochondral Allograft

Haudenschild

Hong

Hatcher

et al. 2012

The Journal of Bone and Joint Surgery-American Volume

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F resh osteochondral allografts have been widely used to treat cartilage lesions for more than 100 years 1 . Transplantation of cartilage and bone in the form of an allograft allows osseous healing while maintaining the articular cartilage architecture. This composite tissue transplant remains intact in vivo for extensive periods of time with a favorable mechanical and biological environment. The chondrocytes of the graft are thought to actively remodel the extracellular matrix environment, and thus contribute to the tissue integrity. We recently reported that allograft cells could survive up to twenty-nine years after transplantation without the need for systemic immunosuppression 2 . Although mosaic cell populations have been demonstrated in other forms of transplantation, these have always been under the umbrella of long-term systemic immunosuppression 3,4 . In a classic study, Langer and Gross 5 showed that intact articular cartilage surfaces obtained by removing the subchondral bone of rat femoral heads and filling of the osseous segments with acrylic cement exhibited essentially no humoral immune response in contrast to that seen with minced cartilage or isolated chondrocyte transplants. This finding has been attributed to the so-called ''immunoprivileged'' status of articular cartilage, which protects the chondrocytes from the immune system of the host.The extent to which allograft chondrocytes retain their gene expression profiles and chondrogenic capacities remains unknown. Our goal was to compare gene expression, proliferation rate, and chondrogenic potential between host and allograft chondrocytes isolated three years after an unsuccessful fresh osteochondral allograft transplant in the knee. The patient was informed that data concerning her case would be submitted for publication, and she provided consent. The study was performed in full compliance with our institutional review board (IRB). Our IRB at University of California Davis Medical Center does not consider case reports to be research and does not expressly provide IRB approval. We have sought IRB approval for case reports on a number of occasions in the past and have been given written documentation of this policy. Case Report Tissue SourceA forty-eight-year-old woman with early osteoarthritis of the knee was treated with a fresh osteochondral allograft with use of cylindrical plugs prepared with commercially available instrumentation (Arthrex, Naples, Florida); the plugs were applied to the trochlea (20 · 20-mm plug), the medial femoral condyle (20 · 20-mm plug), and the lateral femoral condyle (15 · 15-mm plug). The graft was a whole fresh distal part of a femur (University of Miami Tissue Bank, Miami, Florida) from an eighteen-year-old male donor implanted twelve days after harvest. The tissue bank provided the allografts submerged in culture media (RPMI-1640 or lactated Ringer solution) with antibiotics at a refrigerated temperature (1°C to 10°C, never frozen). Transplants approximately 1.0 to 1.5 cm in diameter were created from the regio...

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“…In our study, he was the only diabetic. In addition to the well-documented poor postoperative outcomes of workers' compensation patients in the orthopaedic literature, 21,22 diabetes may have delayed healing and lessened the improvements in pain and function. 23 The extent that each variable contributed to the patient's outcome is beyond the scope of speculation.…”

Section: Discussionmentioning

confidence: 99%