Revision Osteochondral Allograft Transplantations

Horton, Melissa Trujillo; Pulido, Pamela A.; McCauley, Julie C.; Bugbee, William D.

doi:10.1177/0363546513500628

Cited by 49 publications

(52 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Horton et al 32 reported data of 33 knees (mean graft area, 9.5 cm 2 ) that underwent revision OCA transplantation of the knee after failure of primary OCA. All included patients had undergone surgery at least 2 years ago with a minimum follow-up of 2 years.…”

Section: Resultsmentioning

confidence: 99%

“…In these patients, older age, diagnosis of OA, or progression of cartilage disease at the time of revision may be correlated with an increased incidence of failure. 32 In younger patients, revision OCA after failed OCA transplantation may have better results, but this hypothesis should be proved in more specific studies. 25 Patients with previous failed ACI or MACI who underwent further MACI or ACI reported acceptable functional and survivorship results.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

How to Manage a Failed Cartilage Repair: A Systematic Literature Review

Rosa

Donato

Balato

et al. 2017

Joints

View full text Add to dashboard Cite

Purpose The aims of this paper are to report the rate and risk factors for the failure of the most common cartilage repair technique, and analyze the most important factors that could influence the choice of a specific surgical treatment to revise a failed cartilage repair. Methods A review of the literature was performed focusing on failed cartilage repair and related treatments. Two of the authors independently screened articles. Conflicts about the inclusion of a paper was resolved by further evaluation by the senior author. Review articles, articles written in languages different from/other than English, case reports, and papers that did not evaluate the outcomes of interest were excluded. Full-text version of each included paper was obtained and relevant data were extracted and collected in a database. Results At the end of the screening process, 31 articles were included. Microfractures and mosaicplasty showed a nonnegligible failure rate at short- and midterm. Better results, especially in terms of time to failure or revision, were reported with the use of autologous chondrocyte implantation (ACI) and osteochondral allograft (OCA) transplantation. Regarding the treatment of failed cartilage repair, the use of OCA transplantation in patients with previous failed cartilage repair may be a safe option. The revision of failed OCA transplantation with further OCA seems to have a greater failure rate. Patients with previous failed ACI or matrix-induced autologous chondrocyte implantation (MACI) who underwent further MACI or ACI reported acceptable results. Otherwise, ACI in patients with history of previous subchondral marrow stimulation (SMS) demonstrated a greater failure rate. Conclusion From the analysis of the literature, OCA transplantation seems to be the most reliable treatment of a failed SMS. ACI or MACI showed acceptable results in patients with previously failed MACI or ACI. Level of Evidence Level IV, systematic review of level I-IV studies.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

How to Manage a Failed Cartilage Repair: A Systematic Literature Review

Rosa

Donato

Balato

et al. 2017

Joints

View full text Add to dashboard Cite

show abstract

“…Horton et al [ 33 ] report results in 33 patients who had a second OCA after the first failed. At 10 years, 61% of the second OCAs survived, with good symptomatic improvement.…”

Section: Evidence: Primary Studiesmentioning

confidence: 99%

“…In the Horton et al [ 33 ] study, all patients had revision of previous OCA. Some other studies include a few patients having revision OCA (Emmerson 5 OCAs [ 20 ], Gortz 3 [ 26 ], Levy 15 [ 40 ], and Meric 3 [ 47 ]) after failed primary OCA, but do not give results of these separately, probably because of the small numbers.…”

Section: Modellingmentioning

confidence: 99%

The cost-effectiveness of osteochondral allograft transplantation in the knee

Mistry

Metcalfe

Smith

et al. 2019

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

Purpose Osteochondral allografts (OCA) consist of a layer of hyaline cartilage and a layer of underlying bone. They are used to repair combined defects of articular cartilage and bone. Such defects often occur in people far too young to have knee arthroplasty, for whom the main alternative to OCA is conservative symptomatic care, which will not prevent development of osteoarthritis. The aim of this report was to assess the cost-effectiveness of osteochondral allograft transplantation in the knee. Methods Systematic review of evidence on clinical effectiveness and economic modelling. Results The evidence on osteochondral allograft transplantation comes from observational studies, but often based on good quality prospective registries of all patients having such surgery. Without controlled trials, it was necessary to use historical cohorts to assess the effect of osteochondral grafts. There is good evidence that OCA are clinically effective with a high graft survival rate over 20 years. If an OCA graft fails, there is some evidence that revision with a second OCA is also effective, though less so than primary OCA. Economic modelling showed that osteochondral allograft transplantation was highly cost-effective, with costs per quality adjusted life year much lower than many other treatments considered cost effective. Conclusions Osteochondral allograft transplantation appears highly cost-effective though the cost per quality adjusted life year varies according to the widely varying costs of allografts. Based on one small study, revision OCA also appears very cost-effective, but more evidence is needed. Level of evidence II. Electronic supplementary material The online version of this article (10.1007/s00167-019-05392-8) contains supplementary material, which is available to authorized users.

show abstract

“…Nevertheless, when working with these types of materials, the risk of disease transmission or immunogenicity still remains. Moreover, they can be quite brittle leading to the accumulation of microfractures during the remodeling phase [69].…”

Section: Commercially Available Products For Osteochondral Regenerationmentioning

confidence: 99%

Commercial Products for Osteochondral Tissue Repair and Regeneration

Bicho

Pina

Reis

et al. 2018

Osteochondral Tissue Engineering

View full text Add to dashboard Cite

The osteochondral tissue represents a complex structure composed of four interconnected structures, namely hyaline cartilage, a thin layer of calcified cartilage, subchondral bone, and cancellous bone. Due to the several difficulties associated with its repair and regeneration, researchers have developed several studies aiming to restore the native tissue, some of which had led to tissue-engineered commercial products. In this sense, this chapter discusses the good manufacturing practices, regulatory medical conditions and challenges on clinical translations that should be fulfilled regarding the safety and efficacy of the new commercialized products. Furthermore, we review the current osteochondral products that are currently being marketed and applied in the clinical setting, emphasizing the advantages and difficulties of each one.

show abstract

Revision Osteochondral Allograft Transplantations

Cited by 49 publications

References 19 publications

How to Manage a Failed Cartilage Repair: A Systematic Literature Review

How to Manage a Failed Cartilage Repair: A Systematic Literature Review

The cost-effectiveness of osteochondral allograft transplantation in the knee

Commercial Products for Osteochondral Tissue Repair and Regeneration

Contact Info

Product

Resources

About