The Allotransplantation of Partial Joints in the Treatment of Osteoarthritis of the Knee

Gross, A E; Silverstein, Emanuel; Falk, John; Falk, R.; Länger, F

doi:10.1097/00003086-197505000-00003

Cited by 161 publications

(74 citation statements)

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“…resection of knee tumors [26,27]. At the same time, frozen osteochondral allografts were also being used, but over time, the matrix deteriorated due to the absence of viable chondrocytes [47].…”

Section: Fresh Osteochondral Allograftsmentioning

confidence: 99%

“…In addition, there are major therapeutic benefits to unloading Table 1. Indications for optimal use and characteristics producing suboptimal outcomes for the different cartilage repair strategies the compartment that complement the results of a biologic reconstruction [24,26]. The menisci improve the nutritional environment of the articular surfaces and reduce contact stress across the tibiofemoral joint.…”

Section: Patient Selectionmentioning

confidence: 99%

“…This technique allows primitive mesenchymal stem cells to differentiate and form fibrocartilage [17,60]. Dr. Allan Gross popularized the concept of fresh osteochondral allograft transplantation [26,27] and Dr. Lars Peterson is responsible for the first generation of cultured chondrocyte implantation [58]. While there are a number of new emerging technologies at various stages of preclinical and clinical development, most will have their lineage from one of these three distinct approaches.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Cartilage Restoration: Evolution and Overview

Farr

Cole

Dhawan

et al. 2011

Clinical Orthopaedics &Amp; Related Research

216

166

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Background Clinical cartilage restoration is evolving, with established and emerging technologies. Randomized, prospective studies with adequate power comparing the myriad of surgical techniques used to treat chondral injuries are still lacking and it remains a challenge for the surgeon treating patients to make evidence-based decisions. Questions/purposes We reviewed the history of the major cartilage repair/restorative procedures, indications for currently available repair/restorative procedures, and postoperative management. Methods We performed searches using MEDLINE and cartilage-specific key words to identify all Englishlanguage literature. Articles were selected based on their contributions to our current understanding of the basic science and clinical treatment of articular cartilage lesions or historical importance. We then selected 77 articles, two of which are articles of historical importance. Results Current cartilage restorative techniques include débridement, microfracture, osteochondral fragment repair, osteochondral allograft, osteochondral autograft, and autologous chondrocyte transplantation. Pending techniques include two-staged cell-based therapies integrated into a variety of scaffolds, single-stage cell-based therapy, and augmentation of marrow stimulation, each with suggested indications including lesion size, location, and activity demands of the patient. The literature demonstrates variable improvements in pain and function contingent upon multiple variables including indications and application. Conclusions For the patient with symptomatic chondral injury, numerous techniques are available to the surgeon to relieve pain and improve function. Until rigorous clinical trials (prospective, adequately powered, randomized control) are available, treatment decisions should be guided by expert extrapolation of the available literature based in historically sound principles.

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Section: Fresh Osteochondral Allograftsmentioning

confidence: 99%

Section: Patient Selectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Cartilage Restoration: Evolution and Overview

Farr

Cole

Dhawan

et al. 2011

Clinical Orthopaedics &Amp; Related Research

216

166

View full text Add to dashboard Cite

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“…First attempts included storage in lactated Ringer's solution, however this storage media lacked essential nutrients (e.g. fetal calf serum) for sustained metabolic function of the chondrocytes [3,6,11,12]. Subsequently, development of storage media containing appropriate antibiotics and nutrients were developed with storage conditions utilizing temperatures at 4 and 37 "C. Although early attempts at storage at 4 "C were unsuccessful [5], later studies utilizing articular cartilage attached to the underlying bone demonstrated the usefulness of cold preservation of cartilage allograft materials stored in media at 4°C [ 1, 15,22,29].…”

Section: Introductionmentioning

confidence: 99%

Prolonged‐fresh preservation of intact whole canine femoral condyles for the potential use as osteochondral allografts

Williams

Virdi

Pylawka

et al. 2005

Journal Orthopaedic Research

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Defects in articular cartilage are often repaired with fresh osteochondral grafts. While fresh allografts provide viable chondrocytes, logistic limitations require surgical implantation within seven days of graft harvest. Here, we provide information on cold preservation of whole intact osteochondral materials that retains cartilage cell viability and function, and histologic and biochemical integrity for 28days. Canine femoral condyles were obtained and stored at 4°C for 14,21 or 28days. At the end of the storage period, cartilage was assessed for cell viability, 35S uptake, proteoglycan content and histologic parameters. The most noticeable histologic change was reduced Safranin-0 near the cartilage surface with 14days of cold preservation, but had recovered with 21 and 28days. Cartilage thicknesses did not vary significantly. Cell viability was >%YO at 14days, 75-98% at 21 days and reduced to 65-90% at 28days. Cell function measures showed that the level of 35S04 incorporation was suppressed in samples stored at 4°C. However, no significant differences were seen among groups at 14,21 or 28days of cold preservation. This data has implications for tissue banking protocols for osteochondral allograft material obtained for transplantation suggesting that cold preserved allograft material be implanted within 28days.

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“…Fresh osteochondral allograft transplantation was introduced decades ago [3][4][5][6][7]. While initially reserved for the treatment of large osteochondral defects after trauma or resection of malignant tumors, it has become an increasingly popular choice for acute or degenerative chondral and osteochondral defects in an otherwise healthy joint.…”

Section: Introductionmentioning

confidence: 99%

The use of osteochondral allografts in the management of cartilage defects

Demange

Gomoll

2012

Curr Rev Musculoskelet Med

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Large symptomatic osteochondral defects in a young active population represent a therapeutic challenge for orthopedic surgeons, since standard interventions such as debridement, microfracture and autologous osteochondral transfer are not suitable for the treatment of these larger lesions. Fresh osteochondral allograft transplantation provides a surgical option for these challenging defects, both as a primary procedure and for salvage of prior failed treatment attempts. This article reviews the basic science, indications, technique, and evidence for osteochondral allograft transplantation in the knee.

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The Allotransplantation of Partial Joints in the Treatment of Osteoarthritis of the Knee

Cited by 161 publications

References 0 publications

Clinical Cartilage Restoration: Evolution and Overview

Clinical Cartilage Restoration: Evolution and Overview

Prolonged‐fresh preservation of intact whole canine femoral condyles for the potential use as osteochondral allografts

The use of osteochondral allografts in the management of cartilage defects

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