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A key for success of osteoarticular allografts: transplant a refrigerated allograft early

The fresh osteoarticular allograft needs to be implanted via an open incision that allows access to the joint. In most locations of the knee, these incisions can be small, which helps to avoid any quadriceps muscle shutdown. However, there are times when they are in difficult to access locations where the incisions must be larger to make sure the graft can be properly placed.

One of the keys for success of osteoarticular allografts is transplanting a refrigerated allograft within the first 15-28 days postoperatively. It takes 14 days for assessment of the grafts to make sure there are no viral or bacterial contaminants. We strive to implant the grafts as soon as possible once they have passed testing to try and provide the most viable cells to the patient.

Fresh osteoarticular allografts have been found to result in significant functional and clinical improvement after an average follow up of three years, in our patient who have been treated for a full thickness osteochondral defect to the femoral condyle, with similar outcomes to historical reports in other centers for patients treated with fresh osteoarticular allograft implants.

It is very important that a careful assessment be made as to whether a patient is a candidate for this surgery. In addition, while this procedure is not felt to be a cure for arthritis, many patients can get 10 years or more of significant improved outcomes with this surgery. In effect, this is a “biologic resurfacing” procedure and it is important to recognize that not all patients can return back to full impact activities after the surgery.

Robert LaPrade, MD

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