Fresh osteochondral allograft is a suitable alternative for wide cartilage defect in the knee.
BACKGROUND
There are several surgical options to restore a wide osteochondral defect in the knee. Fresh osteochondral allografts are usually considered a poor alternative due to their difficulties in surgical application. The aim of this work is first to present our experience including the surgical technique and the functional results of patients receiving fresh osteochondral allograft to restore major knee lesions, then, to compare our results with other results presented in literature.


METHODS
Between 2006 and 2011, we treated 11 patients with osteochondral lesion of the knee (Outerbridge IV°). The average lesion size was 10.3 cm(2) (range 3-20 cm(2)). The average age was 34 years (range 18-66). Patients were followed from 12 to 55 months (average of 26.5) through clinical examination, X-ray film and MRI every 3 months for the first year, then every 6 months.


RESULTS
The treatment was successful in 10 patients showing pain regression and mean IKDC subjective score improvements from 27.3 to 58.7. The IKDC objective score also improved of at least one class for each patient except the who failed. The radiographs show good osteointegration in all cases but one.


CONCLUSIONS
Fresh allograft is an effective therapy for osteochondral defects repair because it allows functional recovery in a considerable number of patients. This technique obtains better results in lesion smaller than 8 cm(2). However larger lesion show good results.


METHODS
Therapeutic study, Level IV.
Modena Policlinic, Department of Orthopaedic Surgery, Modena, Italy. andreagiorgini@hotmail.it
A
A
Giorgini
D
D
Donati
L
L
Cevolani
T
T
Frisoni
F
F
Zambianchi
F
F
Catani
D000328:Adult; D000368:Aged; D016025:Bone Transplantation / Q000379:methods*; D002358:Cartilage, Articular / Q000293:injuries / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006085:Graft Survival; D006801:Humans; D007592:Joint Diseases / Q000601:surgery; D007718:Knee Injuries / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D007719:Knee Joint / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012720:Severity of Illness Index; D014184:Transplantation, Homologous; D015599:Trauma Severity Indices; D016896:Treatment Outcome