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FRESH OSTEOCHONDRAL ALLOGRAFTS FOR POST-TRAUMATIC OSTEOCHONDRAL DEFECTS OF THE KNEE

M. T. Ghazavi, MD, Clinical Fellow1; K. P. Pritzker, MD, Pathologist-in-Chief2; A. M. Davis, BSc, PhD, PT, Director of Research1; and A. E. Gross, MD, FRCS C, Head1

1 Division of Orthopaedic Surgery
2 Mount Sinai Hospital, 600 University Avenue, Suite 476A, Toronto, Ontario, Canada M5G 1X5.

Correspondence should be sent to Dr A. E. Gross.

We used fresh small-fragment osteochondral allografts to reconstruct post-traumatic osteochondral defects in 126 knees of 123 patients with a mean age of 35 years. At a mean follow-up of 7.5 years (2 to 20), 108 knees were rated as successful (85%) and 18 had failed (15%).

The factors related to failure included age over 50 years (p = 0.008), bipolar defects (p < 0.05), malaligned knees with overstressing of the grafts, and workers’ compensation cases (p < 0.04). Collapse of the graft by more than 3 mm and of the joint space of more than 50% were seen more frequently in radiographs of failed grafts.

Our encouraging clinical results for fresh small-fragment osteochondral allografts show that they are indicated for unipolar post-traumatic osteochondral defects of the knee in young active patients.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General