scholarly journals Osteochondral Autograft Transfer for Focal Cartilage Lesions of the Knee With Donor-Site Back-Fill Using Precut Osteochondral Allograft Plugs and Micronized Extracellular Cartilage Augmentation

2021 ◽  
Vol 10 (1) ◽  
pp. e181-e192
Author(s):  
Evan E. Vellios ◽  
Kristofer J. Jones ◽  
Riley J. Williams
Keyword(s):  
Donor Site ◽  
Osteochondral Allograft ◽  
Osteochondral Autograft ◽  
Cartilage Lesions ◽  
Osteochondral Autograft Transfer

Trends in the Surgical Treatment of Articular Cartilage Lesions in the United States from 2007 to 2016

2020 ◽  
Author(s):  
Steven F. DeFroda ◽  
Steven L. Bokshan ◽  
Daniel S. Yang ◽  
Alan H. Daniels ◽  
Brett D. Owens
Keyword(s):  
United States ◽  
Sports Medicine ◽  
Linear Trend ◽  
The United States ◽  
Osteochondral Allograft ◽  
Osteochondral Autograft ◽  
Cartilage Lesions ◽  
Average Yearly Incidence ◽  
Chondrocyte Implantation ◽  
Osteochondral Autograft Transfer

AbstractManagement of cartilage lesions of the knee can be complex, time consuming, and controversial, especially without a widely agreed upon “gold-standard” management. The PearlDiver database (www.pearldiverinc.com, Fort Wayne, IN) was queried for surgical management of cartilage lesions specified by Current Procedure Terminology (CPT) codes: 29877, chondroplasty; 29879, microfracture/drilling; 29866, arthroscopic osteochondral autograft; 29867, arthroscopic osteochondral allograft; 27412, autologous chondrocyte implantation (ACI); 27415, open osteochondral allograft; or 27416, open osteochondral autograft. Procedures were categorized as palliative (chondroplasty), microfracture/drilling, or restorative (arthroscopic osteochondral autograft; arthroscopic osteochondral allograft; ACI; open osteochondral allograft; or open osteochondral autograft). Linear regression was performed to determine the significance of yearly trend across each procedure.From 2007 to 2016, a total of 35,506 surgical procedures were performed. The average yearly incidence was 7.8 per 10,000 patients. Overall, palliative techniques (chondroplasty) were more common (1.8:1 ratio for chondroplasty to microfracture and 34:1 ratio chondroplasty to restoration procedure). There was a trend of decreasing incidence of palliative procedures seen by a significant decrease in the ratio of palliative to microfracture/restorative procedures of 0.2512 each year from 2007 to 2016 (p < 0.001). This decrease followed a linear trend (R 2 = 0.9123). In 2013, the number and incidence of the palliative procedures declined below that of microfracture procedures, with microfracture being most common from 2013 to 2016. Palliative chondroplasty was no longer the most commonly performed procedure for cartilage lesions in the United States from 2007 to 2016, as more surgeons opted for microfracture procedures instead. Restorative procedures (ACI, osteochondral autograft transfer system) remained unchanged over the study period, in accordance with the sports medicine literature; however, early functional outcomes studies do show the equivalency and in some cases superiority compared with microfracture. This is Level III study.

Osteochondral Allograft Transplantation and Osteochondral Autograft Transfer

2018 ◽  
Vol 26 (3) ◽  
pp. 183-188 ◽  
Author(s):  
Austin V. Stone ◽  
David R. Christian ◽  
Michael L. Redondo ◽  
Adam B. Yanke ◽  
Taylor M Southworth ◽  
...  
Keyword(s):  
Osteochondral Allograft ◽  
Osteochondral Autograft ◽  
Allograft Transplantation ◽  
Osteochondral Autograft Transfer

scholarly journals Osteochondral Autograft and Allograft for Osteochondral Lesions of the Talus

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0026
Author(s):  
Keyword(s):  
Cartilage Repair ◽  
Donor Site ◽  
Consensus Meeting ◽  
Osteochondral Lesions ◽  
Evidence Based ◽  
International Consensus ◽  
Osteochondral Autograft ◽  
Cartilage Lesions ◽  
Allograft Transplantation ◽  
Evidence Based Guidelines

Category: Ankle Introduction/Purpose: Cartilage lesions of the talus are a challenging clinical pathology for orthopaedic surgeons. To date, the treatment guidelines for these lesions have been based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions on key topics regarding cartilage lesions of the talus. Osteochondral autograft and allograft transplantation are surgical modalities to replace the lesion and were discussed as one portion of the first International Consensus Meeting on Cartilage Repair of the Ankle. The purpose of this abstract is to explain the process and delineate the consensus statements derived from this consensus meeting on the use of osteochondral autograft and allograft for osteochondral lesions of the talus. Methods: 75 national and international experts in cartilage repair of the ankle, representing 25 countries and all six continents, were convened and participated in a process based on the Delphi method of achieving consensus. Experts were assigned to groups separated by topics, including osteochondral autograft and allograft. Questions and statements were drafted within the groups and a comprehensive literature review was performed and, where possible, used to confirm or dispute the recommendations made. In addition, the available evidence for each statement was graded. Once the statements achieved majority vote within the working groups, a vote to the overall group was undertaken. The statements were then further edited on the basis of the discussion and votes within the entirety of the consensus group. A final vote then occurred, and the strength of consensus was characterized as follows: consensus: 51 - 74%; strong consensus: 75 - 99%; unanimous: 100%. Results: 29 statements addressing osteochondral autograft and allograft transplantation for cartilage lesions of the talus reached some degree of consensus. These included conclusions on what lesion types/sizes are amenable to this treatment, optimal donor site sources, use of biological augmentation, prognostic factors, and expected outcomes. There was a consensus that: [1] Osteochondral autograft should be considered in primary cystic lesions greater than 1 cm in diameter. [2] The lateral femoral condyle is the preferred osteochondral autograft donor site. [3] It is unnecessary to backfill an osteochondral autograft donor site. [4] Bulk osteochondral allograft transplant should be used in uncontained lesions that cannot be addressed with an osteochondral autograft. No statement achieved less than an 83% consensus following anonymous voting by the expert group. Conclusion: There is a lack of evidence-based guidelines available to direct treatment for clinicians when managing cartilage lesions of the ankle. This international consensus derived from leaders in the field will assist clinicians with a combination of expert- and evidence-based guidelines to consider in the treatment of a cartilage lesion of the talus using osteochondral autograft or allograft transplantation.

scholarly journals Current solutions for the treatment of chronic articular cartilage defects in the knee

2020 ◽  
Vol 5 (3) ◽  
pp. 156-163 ◽  
Author(s):  
Mukai Chimutengwende-Gordon ◽  
James Donaldson ◽  
George Bentley
Keyword(s):  
Donor Site ◽  
Donor Site Morbidity ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Osteochondral Allograft ◽  
Cartilage Defects ◽  
Rehabilitation Period ◽  
Chondrocyte Implantation ◽  
Osteochondral Autograft Transfer ◽  
Articular Cartilage Defects

Chondral and osteochondral defects in the knee are common and may lead to degenerative joint disease if treated inappropriately. Conventional treatments such as microfracture often result in fibrocartilage formation and are associated with inferior results. Additionally, microfracture is generally unsuitable for the treatment of defects larger than 2–4 cm2. The osteochondral autograft transfer system (OATS) has been shown to produce superior clinical outcomes to microfracture but is technically difficult and may be associated with donor-site morbidity. Osteochondral allograft use is limited by graft availability and failure of cartilage incorporation is an issue. Autologous chondrocyte implantation (ACI) has been shown to result in repair with hyaline-like cartilage but involves a two-stage procedure and is relatively expensive. Rehabilitation after ACI takes 12 months, which is inconvenient and not feasible for athletic patients. Newer methods to regenerate cartilage include autologous stem cell transplantation, which may be performed as a single-stage procedure, can have a shorter rehabilitation period and is less expensive than ACI. Longer-term studies of these methods are needed. Cite this article: EFORT Open Rev 2020;5:156-163. DOI: 10.1302/2058-5241.5.190031

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