title: Review of Mechanical, Processing, and Immunologic Factors Associated With Outcomes of Fresh Osteochondral Allograft Transplantation of the Talus.
abstract: Osteochondral lesions of the talus (OLTs) are an increasingly implicated cause of ankle pain and instability. Several treatment methods exist with varying clinical outcomes. Due in part to successful osteochondral allografting (OCA) in other joints, such as the knee and shoulder, OCA has gained popularity as a treatment option, especially in the setting of large lesions. The clinical outcomes of talar OCA have been inconsistent relative to the positive results observed in other joints. Current literature regarding OCA failure focuses mainly on 3 factors: the effect of graft storage conditions on chondrocyte viability, graft/lesion size, and operative technique. Several preclinical studies have demonstrated the ability for bone and cartilage tissue to invoke an immune response, and a limited number of clinical studies have suggested that this response may have the potential to influence outcomes after transplantation. Further research is warranted to investigate the role of immunological mechanisms as an etiology of OCA failure.
  
  
  METHODS
  Level V, expert opinion.
authors.affiliation: 1 Beaumont Health System, Department of Orthopaedic Research, Royal Oak, MI, USA.
authors.forename: Chikezie N
authors.initials: CN
authors.lastname: Okeagu
authors.affiliation: 1 Beaumont Health System, Department of Orthopaedic Research, Royal Oak, MI, USA.
authors.forename: Erin A
authors.initials: EA
authors.lastname: Baker
authors.affiliation: 1 Beaumont Health System, Department of Orthopaedic Research, Royal Oak, MI, USA.
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Barreras
authors.affiliation: 2 Beaumont Health System, Department of Orthopaedic Surgery, Royal Oak, MI, USA.
authors.forename: Zachary M
authors.initials: ZM
authors.lastname: Vaupel
authors.affiliation: 2 Beaumont Health System, Department of Orthopaedic Surgery, Royal Oak, MI, USA.
authors.forename: Paul T
authors.initials: PT
authors.lastname: Fortin
authors.affiliation: 1 Beaumont Health System, Department of Orthopaedic Research, Royal Oak, MI, USA.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Baker
mesh_terms: D064591:Allografts / Q000503:physiopathology*; D018771:Arthralgia / Q000503:physiopathology*; D016025:Bone Transplantation / Q000379:methods*; D002358:Cartilage, Articular / Q000502:physiology*; D019902:Chondrocytes / Q000502:physiology*; D006801:Humans; D007155:Immunologic Factors / Q000737:chemistry / Q000502:physiology*; D013628:Talus / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery* / Q000637:transplantation*; D014184:Transplantation, Homologous / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D007155:Immunologic Factors
keywords: fresh osteochondral allograft; immune-mediated failure; osteochondral lesion; talus