Osteochondral Allograft Transplantation

Osteochondral allograft transplantation has emerged as a contemporary treatment approach for cartilage defects in the knee, offering promising outcomes for patients with significant cartilage damage. This surgical intervention aims to restore both the cartilage and subchondral bone, thereby maintaining the structural integrity and function of the joint. Cartilage degeneration is a common condition caused by factors such as trauma, overuse, aging, medication, and biomechanical abnormalities. Due to the avascular and low regenerative capacity of cartilage, untreated degeneration can lead to osteoarthritis and impaired joint function. Numerous surgical techniques have been developed to address cartilage defects, with the choice of procedure depending on factors such as defect size, patient age, activity level, and the overall condition of the joint. For smaller, localized defects, bone marrow stimulation techniques like microfracture are commonly used, while larger, deeper lesions are often treated with osteochondral autograft or allograft transplantation. Autologous chondrocyte implantation (ACI) is another option for large defects in younger, active patients, often supplemented with biomechanical realignment procedures like osteotomy when necessary. However, each of these methods presents unique limitations, including variable outcomes and challenges in comparing success rates across techniques. In particular, microfracture often results in weaker fibrocartilage, and autologous chondrocyte implantation requires extended recovery times. In recent years, osteochondral allograft transplantation has gained popularity, particularly for large and complex cartilage lesions. This method involves the transplantation of healthy cartilage and underlying bone from a donor to the damaged area, making it a preferred option for defects exceeding 2 cm 2 or cases where other techniques fail. Its advantages include the ability to restore both cartilage and subchondral bone, yielding more durable long-term outcomes. However, while short-term results have been favorable, data on its long-term efficacy remain limited. While traditional methods for treating cartilage damage, such as microfracture, mosaicplasty, and autologous cartilage implantation, are widely used, these approaches have notable limitations. Microfracture often results in the formation of weak fibrocartilage, mosaicplasty is more suitable for smaller lesions, and autologous cartilage implantation requires a prolonged recovery period. In recent years, osteochondral allograft transplantation has become an increasingly preferred option, particularly for large and complex cartilage lesions, due to its ability to repair both cartilage and subchondral bone. This method holds promise for maintaining joint structural integrity and achieving favorable long-term outcomes. This study aims to introduce and evaluate the effectiveness of this method initiated at Yeditepe University Hospital in Turkey.