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CC BY-NC-ND 4.0 · J Knee Surg 2018; 31(06): 528-535
DOI: 10.1055/s-0037-1604138
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Implantation of a Novel Cryopreserved Viable Osteochondral Allograft for Articular Cartilage Repair in the Knee

C. Thomas Vangsness Jr.
1   Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California
,
Geoffrey Higgs
2   Department of Orthopaedic Surgery and Sports Medicine, OrthoCare Institute, Lumin Health, Plano, Texas
,
James K. Hoffman
3   Department of Orthopaedic Surgery, Coordinated Health, Bethlehem, Pennsylvania
,
Jack Farr
4   Cartilage Restoration Center of Indiana, OrthoIndy Hospital, Indianapolis, Indiana
5   Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana
,
Philip A. Davidson
6   Davidson Orthopedics, Salt Lake City, Utah
,
Farrell Milstein
7   Osiris Therapeutics, Inc., Columbia, Maryland
,
Sandra Geraghty
7   Osiris Therapeutics, Inc., Columbia, Maryland
› Author Affiliations
Further Information

Publication History

25 May 2016

31 May 2017

Publication Date:
24 July 2017 (online)

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Abstract

Restoration and repair of articular cartilage injuries remain a challenge for orthopaedic surgeons. The standard first-line treatment of articular cartilage lesions is marrow stimulation; however, this procedure can often result in the generation of fibrous repair cartilage rather than the biomechanically superior hyaline cartilage. Marrow stimulation is also often limited to smaller lesions, less than 2 cm2. Larger lesions may require implantation of a fresh osteochondal allograft, though a short shelf life, size-matched donor requirements, potential challenges of bone healing, limited availability, and the relatively high price limit the wide use of this therapeutic approach. We present a straightforward, single-stage surgical technique of a novel reparative and restorative approach for articular cartilage repair with the implantation of a cryopreserved viable osteochondral allograft (CVOCA). The CVOCA contains full-thickness articular cartilage and a thin layer of subchondral bone, and maintains the intact native cartilage architecture with viable chondrocytes, growth factors, and extracellular matrix proteins to promote articular cartilage repair. We report the results of a retrospective case series of three patients who presented with articular cartilage lesions more than 2 cm2 and were treated with the CVOCA using the presented surgical technique. Patients were followed up to 2 years after implantation of the CVOCA and all three patients had satisfactory outcomes without adverse events. Controlled randomized studies are suggested for evaluation of CVOCA efficacy, safety, and long-term outcomes.

Keywords

osteochondral allograft - articular cartilage repair - cryopreservation - marrow stimulation
 

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