Transplantation of Osteochondral Allografts

Osteochondral allografts represent an alternative source of satisfactory tissue for reconstruction of skeletal deficits associated with traumatic, degenerative, and neoplastic disorders of the skeleton. Methods of banking (donor selection, tissue removal and preservation) have been developed that are compatible with long-term storage of bacteriologically safe and biologically effective bone and cartilage grafts. Immune responses to graft-associated antigens have been evaluated, but their biological significance remains unknown. The use of massive osteochondral allografts in limb-sparing approaches to the treatment of bone tumors has been particularly rewarding. Provided that the lesion is appropriately resected, the graft is properly implanted and protected, and infection is avoided, good and excellent clinical results can be anticipated in 75-80% of the cases.