Topographic Cartilage and Osseous Matching of a Single Oblong Osteochondral Allograft for Cartilage Defect Treatment on the Medial Femoral Condyle

2019 ◽  
Vol 35 (12) ◽  
pp. e20
Author(s):  
Adam B. Yanke ◽  
Michael L. Redondo ◽  
David R. Christian ◽  
Nozomu Inoue ◽  
Brian J. Cole
Keyword(s):  
Cartilage Defect ◽  
Femoral Condyle ◽  
Medial Femoral Condyle ◽  
Osteochondral Allograft

scholarly journals Osteochondral Allograft Transplantation for Treatment of Medial Femoral Condyle Defect

2017 ◽  
Vol 6 (4) ◽  
pp. e1239-e1244 ◽  
Author(s):  
Jonathan A. Godin ◽  
George Sanchez ◽  
Mark E. Cinque ◽  
Jorge Chahla ◽  
Nicholas I. Kennedy ◽  
...  
Keyword(s):  
Femoral Condyle ◽  
Medial Femoral Condyle ◽  
Osteochondral Allograft ◽  
Allograft Transplantation

Medial Femoral Condyle Cartilage Defect Biomechanics

2015 ◽  
Vol 44 (2) ◽  
pp. 409-416 ◽  
Author(s):  
Kyle W. Lacy ◽  
Allison Cracchiolo ◽  
Stephen Yu ◽  
Henry Goitz
Keyword(s):  
Cartilage Defect ◽  
Femoral Condyle ◽  
Medial Femoral Condyle

scholarly journals Clinical Outcomes of ProChondrix® Osteochondral Allograft in the Knee: A Case Series

2021 ◽  
Author(s):  
Michael S. Barnum ◽  
Evan D. Boyd ◽  
Annabelle P. Davey ◽  
Andrew Slauterbeck ◽  
James R. Slauterbeck
Keyword(s):  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Cartilage Defect ◽  
Femoral Condyle ◽  
Case Series ◽  
Activity Level ◽  
Osteochondral Allograft ◽  
Cartilage Restoration ◽  
Patient Reported

Abstract PurposeFocal articular cartilage injuries are common and may lead to progression of osteoarthritis. The complications associated with traditional treatment strategies have influenced the development of new biotechnologies, such as the ProChondrix® osteochondral allograft. Clinical evidence on the outcomes associated with ProChondrix® osteochondral allografts are limited. Thus, the primary purpose of this study was to evaluate the clinical outcomes following treatment of an isolated cartilage defect with a ProChondrix® osteochondral allograft implant.MethodsRetrospective analysis of patients who underwent a cartilage restoration procedure using ProChondrix® osteochondral allograft has been performed. Patients completed patient-reported outcome surveys which included the Knee injury and Osteoarthritis Outcome Score (KOOS), consisting of the 5 subscales of Pain, Symptoms, Activities of Daily Living, Sports and Recreation, and Quality of Life, the Marx Activity Scale, and the visual analog pain scale.ResultsSix patients underwent a cartilage restoration procedure using ProChondrix® between January 2016 and December 2019. Three males and three females were included with a median age of 33.5 years (range 18–48 years). The median follow-up duration was 15 months (range 9–24 months). There were 4 patellar grafts, 1 medial femoral condyle graft, and 1 lateral femoral condyle graft, with a median defect size of 18.5mm (range 13-20mm). At the most recent clinical follow-up, all six patients were pain free and all patients had returned to pre-op activity level.ConclusionTo our knowledge, this is the first study to report the clinical outcome, activity level, and patient orientated outcomes in a case series of patients following treatment of an isolated cartilage defect with a ProChondrix® osteochondral allograft implant. Our study demonstrates promising short-term results in patient reported clinical outcome scores.

scholarly journals Fresh Osteochondral Allograft Transplantation for Spontaneous Osteonecrosis of the Knee: A Case Series

2017 ◽  
Vol 5 (10) ◽  
pp. 232596711773054 ◽  
Author(s):  
Luís E.P. Tírico ◽  
Samuel A. Early ◽  
Julie C. McCauley ◽  
William D. Bugbee
Keyword(s):  
Conservative Treatment ◽  
Femoral Condyle ◽  
Case Series ◽  
Lesion Size ◽  
Medial Femoral Condyle ◽  
Osteochondral Allograft ◽  
Definitive Treatment ◽  
Spontaneous Osteonecrosis ◽  
Fresh Osteochondral Allograft

Background: Spontaneous osteonecrosis of the knee (SONK) is a clinical entity identified by acute knee pain usually associated with joint effusion, with radiographic findings of a radiolucent defect on the weightbearing area of the femoral condyle. Conservative treatment is initially undertaken; however, surgical procedures are often necessary. Historically, surgical options have included core decompression, cartilage repair, high tibial osteotomy, or joint arthroplasty. Few studies in the literature have reported the use of fresh osteochondral allograft (OCA) for the treatment of SONK lesions. Hypothesis: OCA transplantation is an effective treatment for SONK lesions on the medial femoral condyle. Study Design: Case series; Level of evidence, 4. Methods: A case series was analyzed of 7 patients treated with OCA for large SONK lesions of the medial femoral condyle with a minimum 4-year follow-up. All patients experienced failure of at least 6 months of conservative treatment and declined arthroplasty as the form of definitive treatment for medial femoral condyle lesion. All patients underwent OCA of the medial femoral condyle. Mean lesion size was 4.6 cm2 (range, 3.24-6.25 cm2), with a mean condylar width of 41.7 mm (range, 35.4-48.6 mm), resulting in a median proportion (lesion size/condylar width) of 56.8% (range, 32.7%-62.6%). The median surface allograft area was 5.1 cm2 (range, 3.2-6.3 cm2). Results: The median follow-up was 7.1 years (range, 4.5-14.1 years). No patient had additional surgery following OCA transplant; the allograft failure rate was 0%. Subjective outcome scores from the International Knee Documentation Committee, Knee injury and Osteoarthritis Outcome Score, and modified Merle d’Aubigné-Postel scale improved from preoperative assessment to the latest follow-up. All patients were extremely satisfied with the results of the OCA transplant. Conclusion: Fresh OCA transplantation demonstrated excellent efficacy, durability, and satisfaction in this group of patients with isolated stage 2 and 3 SONK lesions who had experienced failure of conservative treatment. Fresh osteochondral allografts are an attractive method for surgical management of selected patients with spontaneous osteonecrosis of the knee.

Return to Sport Following High Tibial Osteotomy With Concomitant Osteochondral Allograft Transplantation

2020 ◽  
Vol 48 (8) ◽  
pp. 1945-1952 ◽  
Author(s):  
Joseph N. Liu ◽  
Avinesh Agarwalla ◽  
David R. Christian ◽  
Grant H. Garcia ◽  
Michael L. Redondo ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Femoral Condyle ◽  
Varus Deformity ◽  
Medial Femoral Condyle ◽  
Osteochondral Allograft ◽  
Return To Sports ◽  
Tibial Osteotomy ◽  
Allograft Transplantation ◽  
Chondral Defects

Background: Young patients with symptomatic chondral defects in the medial compartment with varus malalignment may undergo opening wedge high tibial osteotomy (HTO) with concomitant osteochondral allograft transplantation (OCA) (HTO + OCA). Although patients have demonstrated favorable outcomes after HTO + OCA, limited information is available regarding return to sporting activities after this procedure. Purpose: To evaluate (1) the timeline to return to sports (RTS), (2) patient satisfaction, and (3) reasons for discontinuing sporting activity after HTO + OCA, and to identify predictive factors of RTS. Study Design: Case series; level of evidence, 4. Methods: Consecutive patients who underwent HTO + OCA for varus deformity and medial femoral condyle focal chondral defects with a minimum 2-year follow-up were retrospectively reviewed. Patients completed a subjective sports questionnaire, satisfaction questionnaire, visual analog scale for pain, and Single Assessment Numerical Evaluation. Results: Twenty-eight patients with a mean age of 36.97 ± 7.52 years were included at mean follow-up of 6.63 ± 4.06 years. Fourteen patients (50.0%) required reoperation during the follow-up period, with 3 (10.7%) undergoing knee arthroplasty. Twenty-four patients participated in sports within 3 years before surgery, with 19 patients (79.2%) able to return to at least 1 sport at a mean 11.41 ± 6.42 months postoperatively. However, only 41.7% (n = 10) were able to return to their preoperative level. The most common reasons for sports discontinuation (n = 20; 83.3%) were a desire to prevent further damage to the knee (70.0%), persistent pain (55.0%), persistent swelling (30.0%), and fear (25.0%). Conclusion: In young, active patients with varus deformity and focal medial femoral condyle chondral defects, HTO + OCA enabled 79.2% of patients to RTS by 11.41 ± 6.42 months postoperatively. However, only 41.7% of patients were able to return to their preinjury level or better. It is imperative that patients be appropriately educated to manage postoperative expectations regarding sports participation after HTO + OCA.

scholarly journals Contralateral Lateral Femoral Condyle Allografts Provide an Acceptable Surface Match for Simulated Classic Osteochondritis Dissecans Lesions of the Medial Femoral Condyle

2020 ◽  
Vol 8 (1) ◽  
pp. 232596711989841
Author(s):  
Nabeel Salka ◽  
John A. Grant
Keyword(s):  
Osteochondritis Dissecans ◽  
Femoral Condyle ◽  
Random Order ◽  
Medial Femoral Condyle ◽  
Lateral Femoral Condyle ◽  
Osteochondral Allograft ◽  
Effective Technique ◽  
Percentage Area ◽  
Surface Deviation ◽  
Fresh Frozen

Background: Osteochondral allograft transplantation is an effective technique for repairing large lesions of the medial femoral condyle (MFC), but its use is limited by graft availability. Purpose/Hypothesis: The present study aimed to determine whether contralateral lateral femoral condyle (LFC) allografts can provide an acceptable surface match for posterolateral MFC lesions characteristic of classic osteochondritis dissecans (OCD). The hypothesis was that LFC and MFC allografts will provide similar surface contour matches in all 4 quadrants of the graft for posterolateral MFC lesions characteristic of OCD. Study Design: Controlled laboratory study. Methods: Ten fresh-frozen recipient human MFCs were each size-matched to 1 ipsilateral medial and 1 contralateral LFC donor (N = 30 condyles). After a nano–computed tomography (nano-CT) scan of the native recipient condyle, a 20-mm circular osteochondral “defect” was created 1 cm posterior and 1 cm medial to the roof of the intercondylar notch (n = 10). A size-matched, random-order donor MFC or LFC plug was then harvested, transplanted, and scanned with nano-CT. Nano-CT scans were then reconstructed, registered to the initial scan of the recipient MFC, and processed in MATLAB to determine the height deviation ( d RMS) between the native and donor surfaces and percentage area unacceptably (>1 mm) proud (% A proud) and sunken (% A sunk). Circumferential step-off height ( h RMS) and percentage circumference unacceptably (>1 mm) proud (% C proud) and sunken (% C sunk) were measured using DragonFly software. The process was then repeated for the other allograft plug. Results: Both MFC and LFC plugs showed acceptable step-off heights in all 4 quadrants (range, 0.53-0.94 mm). Neither allograft type nor location within the defect had a significant effect on step-off height ( h RMS), surface deviation ( d RMS), % A proud, or % A sunk. In general, plugs were more unacceptably sunken than proud (MFC, 13.4% vs 2.4%; LFC, 13.2% vs 8.1%), although no significant differences in % C sunk were seen between allograft types or locations within the defect. In LFC plugs, % C proud in the lateral quadrant (28.0% ± 26.1%) was significantly greater compared with all other quadrants ( P = .0002). Conclusion: The present study demonstrates that 20-mm contralateral LFC allografts provide an acceptable surface match for posterolateral MFC lesions characteristic of OCD. Clinical Relevance: With comparable surface matching, MFC and LFC allografts can be expected to present similar stresses on the knee joint and achieve predictably positive clinical outcomes, thus improving donor availability and reducing surgical wait times for matches.

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