Osteochondral resurfacing of the knee joint with allograft. Clinical analysis of 33 cases.

Abstract

This retrospective clinical study describes three years of experience with cryoprotected-cryopreserved allograft transplantation. During this period 33 knee joints were operated on for different reasons including osteoarthritis, osteochondritis dissecans and post-traumatic surface irregularity. The mean follow-up was nearly two years and the mean age of the patients was 48 years. The grafts were harvested and processed at the West Hungarian Tissue Bank according to the criteria promulgated by the European Association of Tissue Banks. All the operations were performed in the same way. Three types of grafts were used: cylindrical or mushroom-shaped for the femoral condyle and patellar and shell allografts for resurfacing the tibial plateau. Bone matrix gelatine (BMG) and fibrin sealant (Tissucol) were used locally to enhance the revascularisation and to improve the decreased osteoinductivity of the frozen cancellous bone. According to the modified Bentley score, the success rate of the short term follow-up was similar to that of other reported series. An analysis of four biopsies showed that the BMG and fibrin sealant did not appear to affect the viability of the articular cartilage. We conclude that application of these materials is not contra-indicated in allograft surgery.