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The Use of Fresh Osteochondral Allografts to Replace Traumatic Joint Defects

  • A. E. Gross
  • R. J. Beaver
  • D. J. Zukor
  • A. Czitrom
  • M. T. Ghazavi

Abstract

The scientific rationale for utilizing fresh rather than preserved osteochondral allografts is as follows. Cartilage harvested without a blood supply within 24 hours of the death of the donor is 100% viable and can be preserved for up to 4 days at 40° C. This has been shown both experimentally and clinically [4,8,12,27,29,30,32,33,42,6,37,47,11,28,9, 23]. The bone whether fresh or preserved, is not viable because of its inability to survive without immediate vascularization, but remains structurally intact and mechanically strong until it is replaced by host bone by creeping substitution [3, 11, 28, 30] or weakened and absorbed by invasion of granulation tissue. Freezing on the other hand kills the cartilage [39]. Even with cryopreservation, the best viability rates that could be achieved varied from 15 to 50% using glycerol or DM SO (dimethyl sulfoxide) and controlled rates of freezing and thawing [5,40,44,45,38,19]. It has also been shown that freezing decreases the immunogenicity of the bone, but does not ablate it completely [13]. Fresh bone is more immunogenic than frozen bone, but there is not enough of a difference to affect the clinical outcome [13]. It has been shown that chondrocytes are immunogenic [14] but when surrounded by matrix they are isolated from the immunocompetent cells and do not sensitize the host.

Keywords

Articular Cartilage Medial Femoral Condyle Tibial Plateau Fracture Lateral Tibial Plateau Osteochondral Allograft 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag/Wien 1996

Authors and Affiliations

  • A. E. Gross
    • 1
  • R. J. Beaver
    • 2
  • D. J. Zukor
    • 3
  • A. Czitrom
    • 4
  • M. T. Ghazavi
    • 1
  1. 1.Division of Orthopaedic SurgeryMount Sinai HospitalTorontoCanada
  2. 2.Royal Perth HospitalPerthAustralia
  3. 3.Department of Orthopaedic Surgery, Jewish General HospitalMcGill UniversityMontrealCanada
  4. 4.Orthopaedic Center of DallasDallasUSA

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