Osteochondral autograft or allograft?
For smaller defects autograft can be used, where the plug of cartilage and bone is harvested from the patient rather than a donor. Small plugs are harvested along the outer edges of the groove of the femur where there is less weight being borne. If the defect is too large for a single plug (OATS) then smaller plugs can be packed like a mosaic into the prepared area (mosaicplasty).
For larger defects, cadaver material can be purchased (pre-sterilised) and the plugs can be taken from that source (allograft).
Outcomes of osteochondral graft surgery
The procedure generally has good outcomes.
OCA transplantation performed in all settings yielded effective long-term results, with graft survivorship of 83% at 10 years postoperatively. Patient age ≥30 years, BMI of ≥30 kg/m2, diagnosis, and graft size >8 cm2 were independently associated with a higher risk of treatment failure when controlling for other variables.
Other relevant links on KNEEguru
A-Z Keywords -
- Allograft, Cartilage repair, OATS, Osteoarticular transfer system, Cartilage, Microfracture, ACI, Mosaicplasty, MACI
Forum discussions
- Patellar osteochondral allograft - Options for articular cartilage repair
Flowchart -
Dr Sheila Strover - 2018 - Arthritis Flowchart
Primer -
Dr Sheila Strover - 2016 - Osteoarthritis Management Options
eBook -
Dr Sheila Strover - Knee arthritis interventions when you are too young for a total knee replacement