Skip to main content
SpringerLink
Log in

Osteochondral Autograft Transfer

  • Chapter
  • First Online:
Cartilage Restoration

  • 760 Accesses

Abstract

Osteochondral autograft transfer (OAT) is indicated for treatment of symptomatic osteochondral defects in the size range of 1–4 cm2. OAT consists of transferring osteochondral autografts from areas with intact articular cartilage subject to less mechanical loads to more mechanically loaded areas with focal, symptomatic osteochondral defects. A major advantage of this technique is the reconstitution of the native osteochondral architecture comprised of a hyaline cartilage surface with underlying subchondral bone. Limitations include donor site morbidity that limits treatment of larger-sized defects. Successful clinical outcomes have been reported with significant improvements in pain and function scores. In this chapter, the current state of the art of the OAT technique will be reviewed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

ACI:

Autologous chondrocyte implantation

CPM:

Continuous passive motion

dGEMRIC:

3D delayed gadolinium-enhanced MRI of cartilage

FSE:

Fast spin-echo

GRASS-IDEAL:

Gradient refocused acquisition in the steady-state and iterative decomposition of water and fat with echo asymmetry and least-squares estimation

HSS:

Hospital for Special Surgery

ICRS:

International Cartilage Repair Society

IKDC:

International Knee Documentation Committee

KOOS:

Knee Injury and Osteoarthritis Outcome Score

MOCART:

Magnetic resonance observation of cartilage repair tissue

MRI:

Magnetic resonance imaging

OAT:

Osteochondral autograft transfer

OCD:

Osteochondritis dissecans

SSFP:

Isotropic three-dimensional steady-state free procession

VTE:

Venous thromboembolism

References

  1. Mithoefer K, McAdams T, Williams RJ, Kreuz PC, Mandelbaum BR. Clinical efficacy of the microfracture technique for articular cartilage repair in the knee: an evidence-based systematic analysis. Am J Sports Med. 2009;37(10):2053–63.

    Article  PubMed  Google Scholar 

  2. Campanacci M, Cervellati C, Donati U. Autogenous patella as replacement for a resected femoral or tibial condyle. A report on 19 cases. J Bone Joint Surg Br. 1985;67(4):557–63.

    Article  CAS  PubMed  Google Scholar 

  3. Yamashita F, Sakakida K, Suzu F, Takai S. The transplantation of an autogenic osteochondral fragment for osteochondritis dissecans of the knee. Clin Orthop Relat Res. 1985;201:43–50.

    Google Scholar 

  4. Outerbridge HK, Outerbridge RE, Smith DE. Osteochondral defects in the knee. A treatment using lateral patella autografts. Clin Orthop Relat Res. 2000;377:145–51.

    Article  Google Scholar 

  5. Agneskirchner JD, Brucker P, Burkart A, Imhoff AB. Large osteochondral defects of the femoral condyle: press-fit transplantation of the posterior femoral condyle (MEGA-OATS). Knee Surg Sports Traumatol Arthrosc. 2002;10(3):160–8.

    Article  PubMed  Google Scholar 

  6. Richter DL, Schenck RC Jr, Wascher DC, Treme G. Knee articular cartilage repair and restoration techniques: a review of the literature. Sports Health. 2016;8(2):153–60.

    Article  PubMed  Google Scholar 

  7. Guettler JH, Demetropoulos CK, Yang KH, Jurist KA. Osteochondral defects in the human knee: influence of defect size on cartilage rim stress and load redistribution to surrounding cartilage. Am J Sports Med. 2004;32(6):1451–8.

    Article  PubMed  Google Scholar 

  8. Bartz RL, Kamaric E, Noble PC, Lintner D, Bocell J. Topographic matching of selected donor and recipient sites for osteochondral autografting of the articular surface of the femoral condyles. Am J Sports Med. 2001;29(2):207–12.

    Article  CAS  PubMed  Google Scholar 

  9. Ahmad CS, Cohen ZA, Levine WN, Ateshian GA, Mow VC. Biomechanical and topographic considerations for autologous osteochondral grafting in the knee. Am J Sports Med. 2001;29(2):201–6.

    Article  CAS  PubMed  Google Scholar 

  10. Nishizawa Y, Matsumoto T, Araki D, Nagamune K, Matsushita T, Kurosaka M, et al. Matching articular surfaces of selected donor and recipient sites for cylindrical osteochondral grafts of the femur: quantitative evaluation using a 3-dimensional laser scanner. Am J Sports Med. 2014;42(3):658–64.

    Article  PubMed  Google Scholar 

  11. Thaunat M, Couchon S, Lunn J, Charrois O, Fallet L, Beaufils P. Cartilage thickness matching of selected donor and recipient sites for osteochondral autografting of the medial femoral condyle. Knee Surg Sports Traumatol Arthrosc. 2007;15(4):381–6.

    Article  PubMed  Google Scholar 

  12. Terukina M, Fujioka H, Yoshiya S, Kurosaka M, Makino T, Matsui N, et al. Analysis of the thickness and curvature of articular cartilage of the femoral condyle. Arthroscopy. 2003;19(9):969–73.

    Article  PubMed  Google Scholar 

  13. Burks RT, Greis PE, Arnoczky SP, Scher C. The use of a single osteochondral autograft plug in the treatment of a large osteochondral lesion in the femoral condyle: an experimental study in sheep. Am J Sports Med. 2006;34(2):247–55.

    Article  PubMed  Google Scholar 

  14. Hangody L, Rathonyi GK, Duska Z, Vasarhelyi G, Fules P, Modis L. Autologous osteochondral mosaicplasty. Surgical technique. J Bone Joint Surg Am. 2004;86-A(Suppl 1):65–72.

    Article  Google Scholar 

  15. Pearce SG, Hurtig MB, Clarnette R, Kalra M, Cowan B, Miniaci A. An investigation of 2 techniques for optimizing joint surface congruency using multiple cylindrical osteochondral autografts. Arthroscopy. 2001;17(1):50–5.

    Article  CAS  PubMed  Google Scholar 

  16. Koh JL, Wirsing K, Lautenschlager E, Zhang LO. The effect of graft height mismatch on contact pressure following osteochondral grafting: a biomechanical study. Am J Sports Med. 2004;32(2):317–20.

    Article  PubMed  Google Scholar 

  17. Nakagawa Y, Suzuki T, Kuroki H, Kobayashi M, Okamoto Y, Nakamura T. The effect of surface incongruity of grafted plugs in osteochondral grafting: a report of five cases. Knee Surg Sports Traumatol Arthrosc. 2007;15(5):591–6.

    Article  PubMed  Google Scholar 

  18. Evans PJ, Miniaci A, Hurtig MB. Manual punch versus power harvesting of osteochondral grafts. Arthroscopy. 2004;20(3):306–10.

    Article  PubMed  Google Scholar 

  19. Duchow J, Hess T, Kohn D. Primary stability of press-fit-implanted osteochondral grafts. Influence of graft size, repeated insertion, and harvesting technique. Am J Sports Med. 2000;28(1):24–7.

    Article  CAS  PubMed  Google Scholar 

  20. Huntley JS, Bush PG, McBirnie JM, Simpson AH, Hall AC. Chondrocyte death associated with human femoral osteochondral harvest as performed for mosaicplasty. J Bone Joint Surg Am. 2005;87(2):351–60.

    Article  CAS  PubMed  Google Scholar 

  21. Diduch DR, Chhabra A, Blessey P, Miller MD. Osteochondral autograft plug transfer: achieving perpendicularity. J Knee Surg. 2003;16(1):17–20.

    PubMed  Google Scholar 

  22. Feczko P, Hangody L, Varga J, Bartha L, Dioszegi Z, Bodo G, et al. Experimental results of donor site filling for autologous osteochondral mosaicplasty. Arthroscopy. 2003;19(7):755–61.

    Article  PubMed  Google Scholar 

  23. Schub DL, Frisch NC, Bachmann KR, Winalski C, Saluan PM. Mapping of cartilage depth in the knee and elbow for use in osteochondral autograft procedures. Am J Sports Med. 2013;41(4):903–7.

    Article  PubMed  Google Scholar 

  24. Baltzer AW, Arnold JP. Bone-cartilage transplantation from the ipsilateral knee for chondral lesions of the talus. Arthroscopy. 2005;21(2):159–66.

    Article  PubMed  Google Scholar 

  25. Makino T, Fujioka H, Terukina M, Yoshiya S, Matsui N, Kurosaka M. The effect of graft sizing on osteochondral transplantation. Arthroscopy. 2004;20(8):837–40.

    Article  PubMed  Google Scholar 

  26. Kock NB, Hannink G, van Kampen A, Verdonschot N, van Susante JL, Buma P. Evaluation of subsidence, chondrocyte survival and graft incorporation following autologous osteochondral transplantation. Knee Surg Sports Traumatol Arthrosc. 2011;19(11):1962–70.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Ueblacker P, Burkart A, Imhoff AB. Retrograde cartilage transplantation on the proximal and distal tibia. Arthroscopy. 2004;20(1):73–8.

    Article  PubMed  Google Scholar 

  28. Borazjani BH, Chen AC, Bae WC, Patil S, Sah RL, Firestein GS, et al. Effect of impact on chondrocyte viability during insertion of human osteochondral grafts. J Bone Joint Surg Am. 2006;88(9):1934–43.

    PubMed  Google Scholar 

  29. Kosiur JR, Collins RA. Weight-bearing compared with non-weight-bearing following osteochondral autograft transfer for small defects in weight-bearing areas in the femoral articular cartilage of the knee. J Bone Joint Surg Am. 2014;96(16):e136.

    Article  PubMed  Google Scholar 

  30. Fazalare JA, Griesser MJ, Siston RA, Flanigan DC. The use of continuous passive motion following knee cartilage defect surgery: a systematic review. Orthopedics. 2010;33(12):878.

    PubMed  Google Scholar 

  31. Bentley G, Biant LC, Carrington RW, Akmal M, Goldberg A, Williams AM, et al. A prospective, randomised comparison of autologous chondrocyte implantation versus mosaicplasty for osteochondral defects in the knee. J Bone Joint Surg Br. 2003;85(2):223–30.

    Article  CAS  PubMed  Google Scholar 

  32. Ma HL, Hung SC, Wang ST, Chang MC, Chen TH. Osteochondral autografts transfer for post-traumatic osteochondral defect of the knee-2 to 5 years follow-up. Injury. 2004;35(12):1286–92.

    Article  PubMed  Google Scholar 

  33. Lane JG, Massie JB, Ball ST, Amiel ME, Chen AC, Bae WC, et al. Follow-up of osteochondral plug transfers in a goat model: a 6-month study. Am J Sports Med. 2004;32(6):1440–50.

    Article  PubMed  Google Scholar 

  34. Gaweda K, Walawski J, Weglowski R, Drelich M, Mazurkiewicz T. Early results of one-stage knee extensor realignment and autologous osteochondral grafting. Int Orthop. 2006;30(1):39–42.

    Article  CAS  PubMed  Google Scholar 

  35. Solheim E, Hegna J, Oyen J, Harlem T, Strand T. Results at 10 to 14 years after osteochondral autografting (mosaicplasty) in articular cartilage defects in the knee. Knee. 2013;20(4):287–90.

    Article  PubMed  Google Scholar 

  36. Gudas R, Kalesinskas RJ, Kimtys V, Stankevicius E, Toliusis V, Bernotavicius G, et al. A prospective randomized clinical study of mosaic osteochondral autologous transplantation versus microfracture for the treatment of osteochondral defects in the knee joint in young athletes. Arthroscopy. 2005;21(9):1066–75.

    Article  PubMed  Google Scholar 

  37. Horas U, Pelinkovic D, Herr G, Aigner T, Schnettler R. Autologous chondrocyte implantation and osteochondral cylinder transplantation in cartilage repair of the knee joint. A prospective, comparative trial. J Bone Joint Surg Am. 2003;85-A(2):185–92.

    Article  CAS  PubMed  Google Scholar 

  38. Gudas R, Gudaite A, Pocius A, Gudiene A, Cekanauskas E, Monastyreckiene E, et al. Ten-year follow-up of a prospective, randomized clinical study of mosaic osteochondral autologous transplantation versus microfracture for the treatment of osteochondral defects in the knee joint of athletes. Am J Sports Med. 2012;40(11):2499–508.

    Article  PubMed  Google Scholar 

  39. Reddy S, Pedowitz DI, Parekh SG, Sennett BJ, Okereke E. The morbidity associated with osteochondral harvest from asymptomatic knees for the treatment of osteochondral lesions of the talus. Am J Sports Med. 2007;35(1):80–5.

    Article  PubMed  Google Scholar 

  40. Ansah P, Vogt S, Ueblacker P, Martinek V, Woertler K, Imhoff AB. Osteochondral transplantation to treat osteochondral lesions in the elbow. J Bone Joint Surg Am. 2007;89(10):2188–94.

    PubMed  Google Scholar 

  41. Paul J, Sagstetter A, Kriner M, Imhoff AB, Spang J, Hinterwimmer S. Donor-site morbidity after osteochondral autologous transplantation for lesions of the talus. J Bone Joint Surg Am. 2009;91(7):1683–8.

    Article  CAS  PubMed  Google Scholar 

  42. Tetta C, Busacca M, Moio A, Rinaldi R, Delcogliano M, Kon E, et al. Knee osteochondral autologous transplantation: long-term MR findings and clinical correlations. Eur J Radiol. 2010;76(1):117–23.

    Article  PubMed  Google Scholar 

  43. Zak L, Krusche-Mandl I, Aldrian S, Trattnig S, Marlovits S. Clinical and MRI evaluation of medium- to long-term results after autologous osteochondral transplantation (OCT) in the knee joint. Knee Surg Sports Traumatol Arthrosc. 2014;22(6):1288–97.

    Article  CAS  PubMed  Google Scholar 

  44. Bert JM. Abandoning microfracture of the knee: has the time come? Arthroscopy. 2015;31(3):501–5.

    Article  PubMed  Google Scholar 

  45. Kock N, van Susante J, Wymenga A, Buma P. Histological evaluation of a mosaicplasty of the femoral condyle-retrieval specimens obtained after total knee arthroplasty–a case report. Acta Orthop Scand. 2004;75(4):505–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, Long Island Jewish Medical Center/Northwell Health, New Hyde Park, NY, USA

    Yen Hsun Chen, Yonah Heller, James Mullen & Nicholas A. Sgaglione

  2. Department of Orthopedic Surgery, Northwell Health System, Great Neck, New York, USA

    Nicholas A. Sgaglione

Authors
  1. Yen Hsun Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yonah Heller
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. James Mullen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Nicholas A. Sgaglione
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. OrthoIndy Knee Preservation and Cartilage Restoration Center of Indiana, Indianapolis, Indiana, USA

    Jack Farr

  2. Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA

    Andreas H. Gomoll

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Chen, Y.H., Heller, Y., Mullen, J., Sgaglione, N.A. (2018). Osteochondral Autograft Transfer. In: Farr, J., Gomoll, A. (eds) Cartilage Restoration. Springer, Cham. https://doi.org/10.1007/978-3-319-77152-6_18

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-77152-6_18

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-77151-9

  • Online ISBN: 978-3-319-77152-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation