Effectiveness of Lavage Techniques in Removing Immunogenic Elements from Osteochondral Allografts

Purpose: To compare the current standard saline lavage technique to a combination saline and high-pressure carbon dioxide lavage to determine their ability to remove marrow elements from osteochondral allografts (OCA).


  • The patient immune response associated with OCA transplantation remains unclear
  • Pre-operatively decreasing the amount of antigenic cellular material in OCAs may positively impact graft integrity and longevity
  • OCA plugs harvested from hemi-condyles were randomized to three treatment arms: no lavage, standard saline lavage and simultaneous saline and high-pressure carbon dioxide lavage
  • Both lavage arms exhibited decreased overall remaining marrow elements
  • Using saline alone resulted in removing only half as many marrow elements from the deeper zones of the subchondral bone in comparison to combination saline and high-pressure carbon dioxide
  • Authors deem the decrease in marrow elements significant enough to warrant immediate transition to using a saline and high-pressure carbon dioxide technique during surgery

JRF Ortho Take Away: The use of combination saline and high-pressure carbon dioxide lavage more effectively removes marrow elements from OCAs than the current standard procedure.

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Authors: Maximilian A. Meyer, Mark A. McCarthy, Matthew E. Gitelis, Sarah G. Poland, Atsushi Urita, Susan Chubinskaya, Adam B. Yanke, Brian J. Cole

Published: Cartilage

Institution: Rush University Medical Center

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