Long-Term Survival of Chondrocytes in an Osteochondral Articular Cartilage Allograft. A Case Report*
F. RICHARD CONVERY, M.D.†; WAYNE H. AKESON, M.D.†; DAVID AMIEL, PH.D.†; MARVIN H. MEYERS, M.D.†; ANNA MONOSOV, PH.D.†, SAN DIEGO, CALIFORNIA

Repair of a localized defect in the articular cartilage with a fresh osteochondral shell allograft is an alternative in a young adult for whom non-operative treatment has failed and prosthetic arthroplasty or arthrodesis of the affected joint is not appropriate. At our institution, the lesions most commonly treated with this technique are traumatic osteochondral defects.

Osteochondral allografts have not gained widespread acceptance, as the good results reported with their use have been based on small series with short-term follow-up from only a few centers2,6,9,12,17. This may be related to the lack of a sophisticated system for procuring donors, the lack of proved storage technology, the fear of transmitted disease, and uncertainty regarding a possible immune response to the allograft14,15. In addition, some tissue banks are reluctant to accept the liability for the dissemination of fresh tissue for a procedure that is not widely used. Yet another factor is the paucity of information on the survival and function of the allograft chondrocytes in humans. Despite the lack of substantive studies, a large number of younger patients in whom more accepted procedures have failed or who are not enthusiastic about the expected results of arthroscopic shaving or drilling of cartilaginous defects are being referred for osteochondral allografting.

The present report describes the histological characteristics, viability of the chondrocytes, and biochemical changes in an osteochondral allograft specimen that had been in situ for ten years. It should be noted that the conclusion of this case report cannot be generalized.

Case Report

A twenty-eight-year-old man, who worked as a mail carrier, sustained an injury of the left knee while playing baseball. Shortly after the injury, an arthroscopic débridement was performed because of pain and swelling, and the patient was told that he …


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