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).
Summary:
- 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. 2017 Oct; 8(4): 369–373.
Institution: Rush University Medical Center