scholarly journals Fresh Osteochondral Allograft Transplantation in Osteochondritis Dissecans in the Knee Joint

Life ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 1205
Author(s):  
Tommaso Roberti Di Sarsisa ◽  
Michele Fiore ◽  
Vito Coco ◽  
Marco Govoni ◽  
Leonardo Vivarelli ◽  
...  
Keyword(s):  
Knee Joint ◽  
Osteochondritis Dissecans ◽  
Healing Process ◽  
Survival Rates ◽  
Adult Life ◽  
Clinical Results ◽  
Osteochondral Allograft ◽  
Allograft Transplantation ◽  
Fresh Osteochondral Allograft ◽  
Vascular Insufficiency

Osteochondritis dissecans (OCD) is a chronic and painful joint condition that can occur from childhood through to adult life. Microtrauma, vascular insufficiency, or abnormal endochondral ossification are the most common causes of OCD. Reconstructive techniques for OCD of the knee are typically necessary when either non-operative or reparative/regenerative operative treatments fail, or when the OCD is irreversible. To analyze the clinical outcomes and failure rates of fresh osteochondral allograft transplantation (FOCA) used as a reconstructive strategy in OCD patients, an in-depth search was carried out on the PubMed, Scopus, and Web of Science databases concerning the existing evidence related to the use of FOCA for OCD patients in the knee joint. A total of 646 studies were found through the search and 2 studies were added after a cross-referenced examination of the articles within the bibliography. Six studies with a total of 303 OCD lesions treated with FOCA, with a mean follow-up of 6.3 years, were included. Although a limited number of low-level evidence studies on this topic are available in previous research, satisfactory clinical results and survival rates of the reconstruction are reported. However, to better define the real advantages of FOCA in the healing process of OCD lesions, comparative studies with different techniques are needed.

scholarly journals Fresh Osteochondral Allograft Transplantation for Osteochondritis Dissecans of the Knee

2014 ◽  
Vol 2 (3_suppl) ◽  
pp. 2325967114S0000
Author(s):  
Kamran N. Sadr ◽  
Pamela Pulido ◽  
Julie C. McCauley ◽  
William Bugbee
Keyword(s):  
Osteochondritis Dissecans ◽  
Osteochondral Allograft ◽  
Allograft Transplantation ◽  
Fresh Osteochondral Allograft

Fresh Osteochondral Allografting in the Treatment of Osteochondritis Dissecans of the Femoral Condyle

2007 ◽  
Vol 35 (6) ◽  
pp. 907-914 ◽  
Author(s):  
Bryan C. Emmerson ◽  
Simon Görtz ◽  
Amir A. Jamali ◽  
Christine Chung ◽  
David Amiel ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Osteochondritis Dissecans ◽  
Femoral Condyle ◽  
Osteochondral Allograft ◽  
Patient Questionnaire ◽  
Comprehensive Treatment ◽  
Allograft Transplantation ◽  
Fresh Osteochondral Allograft ◽  
The Mean

Background The treatment of osteochondritis dissecans in the adult knee can be challenging. As part of our comprehensive treatment program, fresh osteochondral allografts have been used in the surgical management of osteochondritis dissecans of the femoral condyle. Hypothesis Fresh osteochondral allograft transplantation will provide a successful surgical treatment for osteochondritis dissecans of the femoral condyle. Study Design Case series; Level of evidence, 4. Methods Sixty-six knees in 64 patients underwent fresh osteochondral allografting for the treatment of osteochondritis dissecans. Each patient was evaluated both preoperatively and postoperatively using an 18-point modified D'Aubigné and Postel scale. Subjective assessment was performed using a patient questionnaire. Radiographs were evaluated preoperatively and postoperatively. Results Mean follow-up was 7.7 years (range, 2-22 years). There were 45 men and 19 women with a mean age of 28.6 years (range, 15-54 years). All patients had undergone previous surgery. Forty-one lesions involved the medial femoral condyle, and 25 involved the lateral femoral condyle. All were osteochondritis dissecans type 3 or 4. The mean allograft size was 7.5 cm2. One knee was lost to follow-up. Of the remaining 65 knees, 47 (72%) were rated good/excellent, 7 (11%) were rated fair, and 1 (2%) was rated poor. Ten patients (15%) underwent reoperation. The mean clinical score improved from 13.0 preoperatively to 16.4 postoperatively (P < .01). Fifty-nine of 64 patients completed questionnaires. Subjective knee function improved from a mean of 3.4 to 8.4 on a 10-point scale (P < .01). Conclusion With greater than 70% good or excellent results, fresh osteochondral allograft transplantation is a successful surgical treatment for osteochondritis dissecans of the femoral condyle.

scholarly journals A Systematic Review of Fresh Osteochondral Allograft Transplantation for Osteochondral Lesions of the Talus

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0038
Author(s):  
Gregory F. Pereira ◽  
John Steele ◽  
Amanda N. Fletcher ◽  
Samuel B. Adams ◽  
Ryan B. Clement
Keyword(s):  
Systematic Review ◽  
Survival Rate ◽  
Graft Survival ◽  
Graft Survival Rate ◽  
Osteochondral Allograft ◽  
Osteochondral Lesions ◽  
Cochrane Central Register ◽  
Allograft Transplantation ◽  
Fresh Osteochondral Allograft

Category: Ankle Introduction/Purpose: The term osteochondral lesion of the talus (OLT) refers to any pathology of the talar articular cartilage and corresponding subchondral bone. In general, OLTs can pose a formidable treatment challenge to the orthopaedic surgeon due to the poor intrinsic ability of cartilage to heal as well as the tenuous vascular supply to the talus. Although many treatment options exist, including microfracture, retrograde drilling, autologous chondrocyte implantation (ACI), and osteochondral autograft transfer system (OATS) these options may be inadequate to treat large cartilage lesions. Osteochondral allografts have demonstrated promise as the primary treatment for OLTs with substantial cartilage and bone involvement. To our knowledge, this is the first systematic review of outcomes after fresh osteochondral allograft transplantation for OLTs. Methods: PudMed, the Cochrane Central Register of Controlled Trials, EMBASE, and Medline were searched using PRISMA guidelines. Studies that evaluated outcomes in adult patients after fresh osteochondral allograft transplantation for chondral defects of the talus were included. Operative results, according to standardized scoring systems, such as the AOFAS Ankle/Hindfoot scale and the Visual Analog Scale were compared across various studies. The methodological quality of the included studies was assessed using the Coleman methodology score. Results: There were a total of 12 eligible studies reporting on 191 patients with OLTs with an average follow-up of 56.8 months (range 6-240). The mean age was 37.5 (range 17-74) years and the overall graft survival rate was 86.6%. The AOFAS Ankle/Hindfoot score was obtained pre- and postoperatively in 6 of the 12 studies and had significant improvements in each (P<0.05). Similarly, the VAS pain score was evaluated in 5 of the 12 studies and showed significant decreases (P<0.05) from pre- to postoperatively with an aggregate mean preoperative VAS score of 7.3 and an aggregate postoperative value of 2.6. The reported short-term complication rate was 0%. The overall failure rate was 13.4% and 21.6% percent of patients had subsequent procedures. Conclusion: The treatment of osteochondral lesions of the talus remains a challenge to orthopaedic surgeons. From this systematic review, one can conclude that osteochondral allograft transplantation for osteochondral lesions of the talus results in predictably favorable outcomes with an impressive graft survival rate and high satisfaction rates at intermediate follow-up. [Table: see text]

scholarly journals Bipolar Fresh Osteochondral Allograft Transplantation and Joint Reconstruction for Patellar and Trochlear Cartilage Defects

2019 ◽  
Vol 8 (12) ◽  
pp. e1533-e1541
Author(s):  
Omid Jalali ◽  
Zachary Vredenburgh ◽  
John Prodromo ◽  
Neilen Benvegnu ◽  
George Frederick “Rick” Hatch
Keyword(s):  
Osteochondral Allograft ◽  
Cartilage Defects ◽  
Joint Reconstruction ◽  
Allograft Transplantation ◽  
Fresh Osteochondral Allograft

scholarly journals Fresh Allograft Replacement for Osteochondral Lesions of the Talus

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0013
Author(s):  
Samuel Adams ◽  
Nicholas Allen ◽  
James Nunley ◽  
Mark Easley
Keyword(s):  
Surface Roughness ◽  
Cartilage Repair ◽  
Subchondral Bone ◽  
Bone Destruction ◽  
Osteochondral Allograft ◽  
Osteochondral Lesions ◽  
Normal Cartilage ◽  
Allograft Transplantation ◽  
Fresh Osteochondral Allograft ◽  
Osteochondral Allografts

Category: Basic Sciences/Biologics Introduction/Purpose: Large osteochondral lesion of the talus (OLT) can be difficult to treat. Although many treatment options exist, fresh osteochondral allograft transplantation has demonstrated promise as the primary treatment for OLTs with substantial cartilage and bone involvement as well as a secondary treatment option after failure of other cartilage repair techniques. Fresh osteochondral allografts are size-matched from organ donors and, in theory, have healthy articular cartilage and bone. However, the quality of allograft cartilage and bone has never been examined with respect to the OLT cartilage and bone being replaced. The purpose of this study was to perform a matched comparison of the cartilage and bone from patients OLTs to the fresh osteochondral allograft replacement. Methods: Discarded intact osteochondral specimens were collected from 8 patients undergoing surgery for an OLT. The specimens included the excised OLT and a portion of the fresh allograft replacement that the same patient received at the time of surgery. Histologic analysis was performed. The safranin-o histology was then scored using the International Cartilage Repair Society (ICRS) histopathology grading and staging system. In this system the grade determines cartilage and bone destruction on a scale of 0 to 6.5, the stage determines the percentage of involvement in the specimen on a scale of 0 to 4, and the total score is the grade multiplied by the stage. The surface roughness was also compared between the OLT and allograft cartilage using ImageJ software (NIH). Paired t-tests were performed on the ICRS grade, stage, and total score, and surface roughness comparing the OLTs and allografts. Significance was set at p<0.05. Results: Gross histological inspection of the samples demonstrated cartilage erosion and subchondral bone destruction in the OLTs. In constrast, the osteochondral allografts demonstrated intact cartilage surface and normal subchondral bone in the allografts (Figure 1). The ICRS grade, stage, and total score were significantly higher in the implanted allografts compared to the resected OLTs (Figure 2); indicating better cartilage and bone morphology for the allografts compared to the OLTs. In fact, the mean grade and stage for the allograft samples were both less than a score of 1 which corresponds to healthy cartilage and bone with less than 10% surface fibrillations. Moreover, the surface roughness of the allograft cartilage was significantly smoother than the OLT cartilage. Conclusion: This is the first study to demonstrate that the use of fresh allograft transplantation for the treatment of OLTs replaces the damaged cartilage and bone with normal or near normal cartilage and bone. The replacement of damaged cartilage and subchondral bone with normal or near normal cartilage and bone may be the reason for improved pain relief and functional outcomes after fresh allograft transplantation for OLTs.

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