Ankle allograft tissue can be used for shoulder reconstructive procedures, such as the use of a fresh distal tibial allograft for reconstruction of glenoid bone defects. This has been done since 2008 with very promising clinical results demonstrating solid bone incorporation.
Fresh talus allografts can be utilized for large Hill-Sachs or Reverse Hill-Sachs defects. The reasons for using talar allograft for the humerus are: 1) the talus ﬁts well for both typical Hill-Sachs and Reverse Hill-Sachs lesions; 2) the ready availability of talus grafts; and 3) no need for size matching.
Two unique options: 1) patients with dysplasia can undergo large OCA transplants with matched patella and trochlea grafts; 2) isolated focal defects can be successfully reconstructed. In dysplasia cases, the entire patella is resurfaced by cutting oﬀ the damaged articular portion from the patient and obtaining a fresh patellar graft. The trochlea is typically transplanted with a 35 mm osteochondral allograft from the donor screened to have a deep groove to address the trochlear dysplasia.