The OSTEOARTHRITIS DEPARTMENT => KNEE ARTHRITIS - Articular cartilage repair => CARTILAGE REPAIR - ACI & MACI (autologous/matrix-induced autologous chondrocyte implantation) => Topic started by: JessToni on February 12, 2003, 03:35:41 AM

Title: osteochondral allograft questions
Post by: JessToni on February 12, 2003, 03:35:41 AM
hi everyone,
I am looking for personal experiences with an osteochondral allograft.  I have heard it is a tough recovery, but i was wondering people's experience.  
I have had three other knee surgeries in the past.  one general scope, one where a dead piece of bone was removed due to an OCD lesion.  the third was a meniscal surgery.  in the surgery that removed the dead bone it was hope that the area would fill itself in withe new tissue.  It did fill in, but irregularly, which leads me to my next surgery.  
the doctor is going to remove that tissue and fill it in with a press fit allograft.  he is also suggesting a osteotomy of the tibia to take weight off that side of the knee.  has anyone had this combination?
also, what were people's waiting times for the allograft surgery?  i have been waiting about 2-3 months for the graft to come in and still no word?  is this normal?
any info/advice would be very helpful.  

Title: Re: osteochondral allograft questions
Post by: Lindsay on February 16, 2003, 03:21:53 PM
Jess, I'm waiting too for the osteochondral allograft. In the UK there seems to only be one surgeon who does it - Richard Villar in Cambridge. I've been on his waiting list now since July 2002 and have just been given a date at end March 2003 for the operation! It seems that getting bone isn't a problem, but getting bone with suitable cartilage is more of one, and I think mine is coming from Canada!
I've been trying to find someone who's had this done but so far not much luck, although I did get some positive feedback from Stacey who is on this site.
Mr Villar talks about 6-12 weeks non weight bearing and up to a year for full recovery but he too is, of course, very positive. I'm going for it to avoid the possibility of full knee replacement in the future. Wish you every success.
Title: Re: osteochondral allograft questions
Post by: JG on February 17, 2003, 08:49:46 PM

I too am now waiting for a graft.  I went on the list last week.  My surgeon said that he usually gets the graft in 4 to 6 weeks.  When I talked to the surgery scheduler on Friday, she said two other people are waiting right now and have been for 2.5 months.  She said that was a little longer than what they see and that my physician was more in line with what she sees.  I am in the US, northern California.  I think I will be waiting at least 3 months, but I am hoping not more than 6 months.

Good luck.
Title: Re: osteochondral allograft questions
Post by: JessToni on February 18, 2003, 05:46:50 AM
I am glad to see I am not the only one waiting for the is quite frustrating!  I am in the US too, New York.  I just talked to my doc about it and he said average wait is about 3 months, which is where i am at now.  i am hoping it is not much longer though.  
Good luck lindsay with your surgery at the end of march!  you will have to report back on it.
Title: Re: osteochondral allograft questions
Post by: Brad on February 25, 2003, 04:40:08 AM
I am waiting as well.  I have been waiting on a graft since around April or May of 2002.   I was set and ready to have surgery on the 20 of June, but my OS did not like the graft.   It had an apparent defect in the area we needed.  So, here I am almost a year later still waiting.  Unfortunetly it appears the FDA shutdowning of cryolife has affected the availability of good grafts.  I am glad to have the extra caution in the graft selection, but I would also like to walk without pain again.   To add to the agony, I have a slightly torn Menicus in the other knee.  But I am planning on waiting until after the allograft to have anything done.   I too was told the average wait was around two to three months.   I now do not even worry about the graft as I feel most days like I am going to be this way for a long time.  I know that we will have the surgery one of these days, but it has been awhile waiting.   So, I guess I will continue to wait and for the most part I can do my daily activities.  But not any sports, stairs or long walking.   I just hope to have it sooner than later, as it feels like the area that is causing pain is getting bigger.  

Title: Re: osteochondral allograft questions
Post by: JG on February 25, 2003, 09:17:21 AM

Where do you live?  When I first read your post, I assumed either Europe or Canada.  But you mentioned the FDA, so maybe the US.  My OS quoted 4 to 6 weeks, but I think it will be more like 3-4 months.  Although the surgery scheduler for my OS said that she has two other patients that are waiting and it has been 2 months which was about what she was seeing as the top end wait recently.  I am in the SF Bay area.  I actually called the MTF (Musculoskeleton Tissue Foundation) today to ask about the average wait and the decision process.  I was unable to talk to the right person; but, I expect to get some idea in the next week.

Good luck...Janice  
Title: Re: osteochondral allograft questions
Post by: JessToni on February 25, 2003, 06:08:12 PM
I cannot believe you have been waiting almost a year already..that is my worst nightmare.  My pain is severe and i have trouble walking more than a couple of blocks, which is a problem living in NYC.  
I was also wondering where you are that you have been waiting so long?
Janice..if you hear anything from the tissue bank, please report back :)

Title: Re: osteochondral allograft questions
Post by: JG on February 25, 2003, 06:33:54 PM

I will let you know.  On the CryoLife front - They were never really "shut down", just under heavy restriction for some time.  This was released recently.  I am not sure whether it is a good thing or bad.  More grafts available, but many will worry about the safety.  I know my surgeon is not consider using them.  I would image that they will be heavily inspected over the next 6 mos to a year.  


Released on February 19, 2003

CryoLife Inc. said yesterday that a recent US Food and Drug Administration inspection cleared the way for it to begin processing orthopedic tissue again. Its shares soared more than 40 percent.

The nation's largest supplier of living human tissue for implantation was ordered last August to stop distributing cadaver tissue. FDA officials said the company, based in Kennesaw, failed to adopt and follow safety procedures to keep fungus and bacteria from contaminating soft tissue.

The government later agreed to allow CryoLife to resume limited distribution of human tissue, but it still could not process orthopedic tissue, about 20 percent of its business.

Orthopedic tissue is soft tissue that includes ligaments and tendons primarily used to reconstruct the knee.

CryoLife said the FDA concluded an inspection Friday and indicated the firm had corrected the safety problems. The FDA still had some concerns about the company's system for handling complaints, but that won't affect operations, CryoLife said.

''This is a significant milestone for the company, and we are preparing to resume processing orthopedic tissues in the near future,'' said president and chief executive Steven G. Anderson.

Chief financial officer D. Ashley Lee said the company will ask the FDA for the go-ahead before resuming full operations, but hopes to be processing orthopedic tissue by the second quarter.

An FDA spokeswoman in Washington declined to comment yesterday.

Shares of CryoLife rose $2.26 to close yesterday at $7.60 on the New York Stock Exchange.

In its decision last summer, the FDA ordered CryoLife to recall all soft tissue processed since Oct. 3, 2001, a month before a Minnesota man died from tainted tissue he received in a knee operation.

Brian Lykins, 23, of Willmar, Minn., died several days after a knee cartilage transplant. CryoLife processed and supplied the cartilage.

The death touched off an investigation by the Centers for Disease Control and Prevention that concluded infections from cadaver tissue used in orthopedic implants are more widespread than previously thought.

Following the FDA order, CryoLife laid off 105 employees. It now has about 280 workers. The company also disclosed that several top executives were given bonuses days after the recall.