The viability of articular cartilage in fresh osteochondral allografts after clinical transplantation.

Background: Osteochondral allograft transplantation is 1 treatment option for focal articular cartilage defects of the knee. Large irregular defects, which can be treated using an oblong allograft or multiple overlapping allografts, increase the procedure’s technical complexity and may provide suboptimal cartilage and subchondral surface matching between donor grafts and recipient sites. Purpose: To quantify and compare cartilage and subchondral surface topography mismatch and cartilage step-off for oblong and overlapping allografts using a 3-dimensional simulation model. Study Design: Controlled laboratory study. Methods: Human cadaveric medial femoral hemicondyles (n = 12) underwent computed tomography and were segmented into cartilage and bone components using 3-dimensional reconstruction and modeling software. Segments were then exported into point-cloud models. Modeled defect sizes of 17 × 30 mm were created on each recipient hemicondyle. There were 2 types of donor allografts from each condyle utilized: overlapping and oblong. Grafts were virtually harvested and implanted to optimally align with the defect to provide minimal cartilage surface topography mismatch. Least mean squares distances were used to measure cartilage and subchondral surface topography mismatch and cartilage step-off. Results: Cartilage and subchondral topography mismatch for the overlapping allograft group was 0.27 ± 0.02 mm and 0.80 ± 0.19 mm, respectively. In comparison, the oblong allograft group had significantly increased cartilage (0.62 ± 0.43 mm; P < .001) and subchondral (1.49 ± 1.10 mm; P < .001) mismatch. Cartilage step-off was also found to be significantly increased in the oblong group compared with the overlapping group ( P < .001). In addition, overlapping allografts more reliably provided a significantly higher percentage of clinically acceptable (0.5- and 1-mm thresholds) cartilage surface topography matching (overlapping: 100% for both 0.5 and 1 mm; oblong: 90% for 1 mm and 56% for 0.5 mm; P < .001) and cartilage step-off (overlapping: 100% for both 0.5 and 1 mm; oblong: 86% for 1 mm and 12% for 0.5 mm; P < .001). Conclusion: This computer simulation study demonstrated improved topography matching and decreased cartilage step-off with overlapping osteochondral allografts compared with oblong osteochondral allografts when using grafts from donors that were not matched to the recipient condyle by size or radius of curvature. These findings suggest that overlapping allografts may be superior in treating large, irregular osteochondral defects involving the femoral condyles with regard to technique. Clinical Relevance: This study suggests that overlapping allografts may provide superior articular cartilage surface topography matching compared with oblong allografts and do so in a more reliable fashion. Surgeons may consider overlapping allografts over oblong allografts because of the increased ease of topography matching during placement.

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Beneficial Storage Effects of Epigallocatechin-3-O-Gallate on the Articular Cartilage of Rabbit Osteochondral Allografts

Cell Transplantation ◽

10.1177/096368970901805-604 ◽

2009 ◽

Vol 18 (5-6) ◽

pp. 505-512 ◽

Cited By ~ 14

Author(s):

Jung Yoon Bae ◽

Kazuaki Matsumura ◽

Shigeyuki Wakitani ◽

Amu Kawaguchi ◽

Sadami Tsutsumi ◽

...

Keyword(s):

Articular Cartilage ◽

Disease Transmission ◽

Culture Medium ◽

Clinical Success ◽

Osteochondral Allograft ◽

Cartilage Defects ◽

Clinical Effects ◽

Normal Cells ◽

Osteochondral Grafts ◽

Osteochondral Allografts

A fresh osteochondral allograft is one of the most effective treatments for cartilage defects of the knee. Despite the clinical success, fresh osteochondral allografts have great limitations in relation to the short storage time that cartilage tissues can be well-preserved. Fresh osteochondral grafts are generally stored in culture medium at 4°C. While the viability of articular cartilage stored in culture medium is significantly diminished within 1 week, appropriate serology testing to minimize the chances for the disease transmission requires a minimum of 2 weeks. (–)-Epigallocatechin-3- O-gallate (EGCG) has differential effects on the proliferation of cancer and normal cells, thus a cytotoxic effect on various cancer cells, but a cytopreservative effect on normal cells. Therefore, a storage solution containing EGCG might extend the storage duration of articular cartilages. Rabbit osteochondral allografts were performed with osteochondral grafts stored at 4°C in culture medium containing EGCG for 2 weeks and then the clinical effects were examined with macroscopic and histological assessment after 4 weeks. The cartilaginous structure of an osteochondral graft stored with EGCG was well-preserved with high cell viability and glycosaminoglycan (GAG) content of the extracellular matrix (ECM). After an osteochondral allograft, the implanted osteochondral grafts stored with EGCG also provided a significantly better retention of the articular cartilage with viability and metabolic activity. These data suggest that EGCG can be an effective storage agent that allows long-term preservation of articular cartilage under cold storage conditions.

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Vitrification of Intact Porcine Femoral Condyle Allografts Using an Optimized Approach

Cartilage ◽

10.1177/1947603520967077 ◽

2020 ◽

pp. 194760352096707

Author(s):

Kezhou Wu ◽

Leila Laouar ◽

Janet A. W. Elliott ◽

Nadr M. Jomha

Keyword(s):

Articular Cartilage ◽

Femoral Condyle ◽

Membrane Integrity ◽

Cartilage Defects ◽

Chondrocyte Viability ◽

Cell Membrane Integrity ◽

A Cell ◽

Vitrification Solution ◽

Femoral Condyles ◽

Osteochondral Allografts

Objective Successful preservation of articular cartilage will increase the availability of osteochondral allografts to treat articular cartilage defects. We compared the effects of 2 methods for storing cartilage tissues using 10-mm diameter osteochondral dowels or femoral condyles at −196°C: (a) storage with a surrounding vitrification solution versus (b) storage without a surrounding vitrification solution. We investigated the effects of 2 additives (chondroitin sulfate and ascorbic acid) for vitrification of articular cartilage. Design Healthy porcine stifle joints ( n = 11) from sexually mature pigs were collected from a slaughterhouse within 6 hours after slaughtering. Dimethyl sulfoxide, ethylene glycol, and propylene glycol were permeated into porcine articular cartilage using an optimized 7-hour 3-step cryoprotectant permeation protocol. Chondrocyte viability was assessed by a cell membrane integrity stain and chondrocyte metabolic function was assessed by alamarBlue assay. Femoral condyles after vitrification were assessed by gross morphology for cartilage fractures. Results There were no differences in the chondrocyte viability (~70%) of 10-mm osteochondral dowels after vitrification with or without the surrounding vitrification solution. Chondrocyte viability in porcine femoral condyles was significantly higher after vitrification without the surrounding vitrification solution (~70%) compared to those with the surrounding vitrification solution (8% to 36%). Moreover, articular cartilage fractures were not seen in femoral condyles vitrified without surrounding vitrification solution compared to fractures seen in condyles with surrounding vitrification solution. Conclusions Vitrification of femoral condyle allografts can be achieved by our optimized approach. Removing the surrounding vitrification solution is advantageous for vitrification outcomes of large size osteochondral allografts.

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The fate of articular cartilage after transplantation of fresh and cryopreserved tissue-antigen-matched and mismatched osteochondral allografts in dogs.

The Journal of Bone and Joint Surgery (American) ◽

10.2106/00004623-198971090-00004 ◽

1989 ◽

Vol 71 (9) ◽

pp. 1297-1307 ◽

Cited By ~ 118

Author(s):

S Stevenson ◽

G A Dannucci ◽

N A Sharkey ◽

R R Pool

Keyword(s):

Articular Cartilage ◽

Tissue Antigen ◽

Osteochondral Allografts

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Treatment of Articular Cartilage Defects in the Goat with Frozen Versus Fresh Osteochondral Allografts

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.k.00439 ◽

2012 ◽

Vol 94 (21) ◽

pp. 1984-1995 ◽

Cited By ~ 37

Author(s):

Andrea L. Pallante ◽

Simon Görtz ◽

Albert C. Chen ◽

Robert M. Healey ◽

Derek C. Chase ◽

...

Keyword(s):

Articular Cartilage ◽

Cartilage Defects ◽

Articular Cartilage Defects ◽

Osteochondral Allografts

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The Effect of Storage on the Biomechanical Behavior of Articular Cartilage—A Large Strain Study

Journal of Biomechanical Engineering ◽

10.1115/1.2895440 ◽

1992 ◽

Vol 114 (1) ◽

pp. 149-153 ◽

Cited By ~ 14

Author(s):

M. K. Kwan ◽

S. A. Hacker ◽

S. L.-Y. Woo ◽

J. S. Wayne

Keyword(s):

Articular Cartilage ◽

Culture Media ◽

Large Strain ◽

Biomechanical Properties ◽

Cartilage Tissue ◽

Total Joint Replacements ◽

Strain Behavior ◽

Biomechanical Behavior ◽

Tissue Culture Media ◽

Osteochondral Allografts

The transplantation of stored shell osteochondral allografts is a potentially useful alternative to total joint replacements for the treatment of joint ailments. The maintenance of normal cartilage properties of the osteochondral allografts during storage is important for the allograft to function properly and survive in the host joint. Since articular cartilage is normally under large physiological stresses, this study was conducted to investigate the biomechanical behavior under large strain conditions of cartilage tissue stored for various time periods (i.e., 3, 7, 28, and 60 days) in tissue culture media. A biphasic large strain theory developed for soft hydrated connective tissues was used to describe and determine the biomechanical properties of the stored cartilage. It was found that articular cartilage stored for up to 60 days maintained the ability to sustain large compressive strains of up to 40 percent or more, like normal articular cartilage. Moreover, the equilibrium stress-strain behavior and compressive modulus of the stored articular cartilage were unchanged after up to 60 days of storage.

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Human Articular Cartilage Storage in Cell Culture Medium: Guidelines for Storage of Fresh Osteochondral Allografts

Orthopedics ◽

10.3928/0147-7447-19970601-04 ◽

1997 ◽

Vol 20 (6) ◽

pp. 497-500

Author(s):

V James Sammarco ◽

Robert Gorab ◽

Robert Miller ◽

Peter J Brooks

Keyword(s):

Cell Culture ◽

Articular Cartilage ◽

Culture Medium ◽

Human Articular Cartilage ◽

Cell Culture Medium ◽

Osteochondral Allografts

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Analysis of Stored Osteochondral Allografts at the Time of Surgical Implantation

The American Journal of Sports Medicine ◽

10.1177/0363546505275010 ◽

2005 ◽

Vol 33 (10) ◽

pp. 1479-1484 ◽

Cited By ~ 77

Author(s):

R. Todd Allen ◽

Catherine M. Robertson ◽

Andrew T. Pennock ◽

William D. Bugbee ◽

Frederick L. Harwood ◽

...

Keyword(s):

Articular Cartilage ◽

Cell Viability ◽

Cell Density ◽

Tissue Bank ◽

Viable Cell ◽

Viable Cell Density ◽

Proteoglycan Synthesis ◽

Superficial Zone ◽

Chondrocyte Viability ◽

Osteochondral Allografts

Background To date, the morphological, biochemical, and biomechanical characteristics of articular cartilage in osteochondral allografts that have been stored have not been fully described. Hypothesis Osteochondral allografts procured and stored commercially for a standard period as determined by tissue banking protocol will have compromised chondrocyte viability but preserved extracellular matrix quality. Study Design Controlled laboratory study. Methods Unused cartilage from 16 consecutive osteochondral allografts was sampled during surgery after tissue bank processing and storage. Ten grafts were examined for cell viability and viable cell density using confocal microscopy, proteoglycan synthesis via 35SO4 uptake, and glycosaminoglycan content and compared with fresh cadaveric articular cartilage. Biomechanical assessment was performed on the 6 remaining grafts by measuring the indentation stiffness of the cartilage. Results The mean storage time for the transplanted specimens was 20.3 ± 2.9 days. Chondrocyte viability, viable cell density, and 35SO4 uptake were significantly lower in allografts at implantation when compared to fresh, unstored controls, whereas matrix characteristics, specifically glycosaminoglycan content and biomechanical measures, were unchanged. In addition, chondrocyte viability in the stored allografts was preferentially decreased in the superficial zone of cartilage. Conclusion Human osteochondral allografts stored for a standard period (approximately 3 weeks) before implantation undergo decreases in cell viability, especially in the critically important superficial zone, as well as in cell density and metabolic activity, whereas matrix and biomechanical characteristics appear conserved. The exact clinical significance of these findings, however, is unknown, as there are no prospective studies examining clinical outcomes using grafts stored for extended periods. Clinical Relevance Surgeons who perform this procedure should understand the cartilage characteristics of the graft after 21 days of commercial storage in serum-free media.

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