J Knee Surg 2012; 25(02): 109-116
DOI: 10.1055/s-0032-1313743
Special Focus Section
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Osteochondral Allograft Transplantation in the Knee

William Bugbee
1   Division of Orthopaedic Surgery, Scripps Clinic, La Jolla, California
,
Marco Cavallo
2   II Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna, Italy
,
Sandro Giannini
2   II Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna, Italy
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Publikationsverlauf

27. Oktober 2011

27. November 2011

Publikationsdatum:
15. Mai 2012 (online)

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Abstract

Fresh osteochondral allograft (OCA) transplantation has over a 100-year clinical history. Many clinical and basic scientific studies have been performed with the result that allografting is now a part of the “cartilage repair paradigm” for the treatment of chondral or osteochondral lesions. In the knee joint, allografting has also been successfully used in complex joint reconstruction for the treatment of osteonecrosis, fracture malunion, and selected cases of osteoarthritis. Unlike many other cartilage repair techniques, OCA have the ability to restore mature, hyaline articular cartilage to the affected area. By virtue of their composite structure (cartilage and bone), allografts also can restore diseased or damaged bone often present in large or complex lesions. Nevertheless, OCA present unique and important difficulties in their clinical application, such as allograft tissue availability, safety issues, and immunologic response to the graft. Ongoing investigations continue to clarify the indications, surgical techniques, and clinical outcomes of fresh OCA.