Osteochondral Allograft Transplantation

Full-thickness articular cartilage lesions can produce a variety of debilitating symptoms and lead to progressive arthrosis. Hyaline cartilage, once damaged, has limited or no capacity for intrinsic healing. These lesions are especially challenging to treat in the younger patient population. Many techniques have been used and described to treat these defects. Restoration of articular cartilage may be considered within the context of a complex algorithm and is dependent on a wide array of individualized variables. Osteochondral allograft transplantation (OAT) represents an important option in treating osteochondral defects. OAT has a long, successful history of clinical usage in treating both full-thickness cartilaginous and osteochondral defects. Clinical reports show excellent survivorship of these grafts, with more than 20 years of follow-up. Safety is a foremost concern when using OAT. Although rare, the transmission of disease is a primary consideration when transplanting viable, nonsterilized, biologic tissue. In light of logistical constraints and legally mandated regulations, the storage of osteochondral allografts has been increasingly used in clinical practice. With these considerations in mind, OAT remains a very attractive option to treat full-thickness chondral and osteochondral defects, typically greater than 2 cm2.