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Case Reports   |    
Twenty-five-Year Chondrocyte Viability in Fresh Osteochondral AllograftA Case Report
A.C. Maury, MD, FRCS(T&O)1; O. Safir, MD, FRCSC1; F. Las Heras, MD1; K.P.H. Pritzker, MD, FRCPC1; A.E. Gross, MD, FRCS1
1 Pathology and Laboratory Medicine (F.L.H. and K.P.H.P) and Department of Surgery, Division of Orthopaedic Surgery (A.C.M., O.S., and A.E.G.), Mount Sinai Hospital, 600 University Avenue, Toronto, ON M5G 1X5, Canada. E-mail address for A.E. Gross: allan.gross@utoronto.ca
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Disclosure: The authors did not receive grants or outside funding in support of their research for or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.
Note: The authors thank Theresa Pirogowicz for preparation of the manuscript.
Investigation performed at Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2007 Jan 01;89(1):159-165. doi: 10.2106/JBJS.E.00815
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Extract

Treatment of osteochondral defects of >3 cm in diameter and >1 cm in depth following trauma or treatment of a neoplasm is a challenge. Surgical options include the use of an osteochondral allograft, arthrodesis, or joint arthroplasty. The longevity of a prosthesis may be too short in young active patients, and arthrodesis may be unacceptable to them. This limits the surgical choice to implantation of an osteochondral allograft1-15. The success of an osteochondral allograft depends on the viability of the articular cartilage3,16 and the stability of the graft bone-host bone interface10,13,17. Freezing grafts to preserve them has been shown to kill chondrocytes and limit graft survival13,14,18-22. Therefore, the technique of using fresh avascular osteochondral shell allografts with ex vivo preservation in saline solution at 4°C was developed23-26. With this technique, tissues are harvested within twenty-four hours after the donor's death, and grafts with a shell of bone subjacent to the articular cartilage are then implanted. Chondrocytes in an allograft implanted with this technique have been reported to survive for up to seventeen years16. In the present report, we describe a case in which the graft survived for twenty-five years posttransplantation and in which graft chondrocytes appeared to be viable under light and electron microscopy. The patient was informed that data concerning the case would be submitted for publication.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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