High Failure Rate of a Decellularized Osteochondral Allograft for the Treatment of Cartilage Lesions

Purpose: To report on functional outcomes and graft survivorship for patients receiving a “sterilized and decellularized osteochondral allograft” (Chondrofix; ZimmerBiomet) implant for knee cartilage injuries.


  • Chondrofix - a pre-shaped, sterilized and decellularized osteochondral allograft implant, was introduced as an alternative to fresh osteochondral allografts
  • Two surgeons from two institutions implanted Chondrofix in 32 patients, making this the largest study to report outcomes on the implant
  • Twenty-three of the 32 knees, or 72%, were considered failures due to structural damage diagnosed by arthroscopy or MRI and any reoperation that resulted in the removal of the graft
  • The implant survivorship was 19.6% at 2 years
  • There was no significant difference in outcomes between patients who had previously underwent other surgical treatment and those who had the implant as their first procedure
  • Age was a significant predictor of failure with a hazard ratio of 1.68 per 1 standard deviation older than the mean (35.1 + 10.6 years)
  • Histologic analysis on Chondrofix plugs removed during a revision procedure demonstrated that very few cells were present and the majority of cartilage was devoid of cells


Take Away: With a 72% failure rate within the first two years of implantation at two institutions, the Chondrofix implant does not exhibit similar outcomes to fresh osteochondral allografts.

Authors: Jack Farr, Guilherme C. Gracitelli, Nehal Shah, Eric Y. Chang and Andreas H. Gomoll

Published: The American Journal of Sports Medicine

Level of Evidence: IV

Institution: OrthoIndy Hospital, Indianapolis, Indiana and Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts

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