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Clinical Orthopaedics and Related Research®

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01-08-2008 | Symposium: New Approaches to Allograft Transplantation

Material Properties of Fresh Cold-stored Allografts for Osteochondral Defects at 1 Year

Authors: Anil S. Ranawat, MD, Armando F. Vidal, MD, Chris T. Chen, PhD, Jonathan A. Zelken, BA, A. Simon Turner, BVSc, Riley J. Williams III, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 8/2008

Abstract

Little is known about the long-term properties of fresh cold-stored osteochondral allograft tissue. We hypothesized fresh cold-stored tissue would yield superior material properties in an in vivo ovine model compared to those using freeze-thawed acellular grafts. In addition, we speculated that a long storage time would yield less successful grafts. We created 10-mm defects in medial femoral condyles of 20 sheep. Defects were reconstructed with allograft plugs stored at 4°C for 1, 14, and 42 days; control specimens were freeze-thawed or defect-only. At 52 weeks, animals were euthanized and retrieved grafts were analyzed for cell viability, gross morphology, histologic grade, and biomechanical and biochemical analysis. Explanted cold-stored tissue had superior histologic scores over freeze-thawed and defect-only grafts. Specimens stored for 1 and 42 days had higher equilibrium moduli and proteoglycan content than freeze-thawed specimens. We observed no difference among any of the cold-stored specimens for chondrocyte viability, histology, equilibrium aggregate modulus, proteoglycan content, or hypotonic swelling. Reconstructing cartilage defects with cold-stored allograft resulted in superior histologic and biomechanical properties compared with acellular freeze-thawed specimens; however, storage time did not appear to be a critical factor in the success of the transplanted allograft.

Allen RT, Robertson CM, Pennock AT, Bugbee WD, Harwood FL, Wong VW, Chen AC, Sah RL, Amiel D. Analysis of stored osteochondral allografts at the time of surgical implantation. Am J Sports Med. 2005;33:1479–1484.PubMedCrossRef

Amiel D, Coutts RD, Abel M, Stewart W, Harwood FL, Akeson WH. Rib perichondrial grafts for the repair of full-thickness articular-cartilage defects. A morphological and biochemical study in rabbits. J Bone Joint Surg Am. 1985;67:911–920.PubMed

Amiel D, Coutts RD, Harwood FL, Ishizue KK, Kleiner JB. The chondrogenesis of rib perichondrial grafts for repair of full thickness articular cartilage defects in a rabbit model: a one year postoperative assessment. Connect Tissue Res. 1988;18:27–39.PubMedCrossRef

Aubin PP, Cheah HK, Davis AM, Gross AE. Long-term followup of fresh femoral osteochondral allografts for posttraumatic knee defects. Clin Orthop Relat Res. 2001;391(Suppl):S318–327.PubMedCrossRef

AVMA Panel on Euthanasia, American Veterinary Medical Association. 2000 Report of the. AVMA Panel on Euthanasia. J Am Vet Med Assoc. 2001;218:669–696.

Bakay A, Csonge L, Papp G, Fekete L. Osteochondral resurfacing of the knee joint with allograft. Clinical analysis of 33 cases. Int Orthop. 1998;22:277–281.PubMedCrossRef

Ball ST, Amiel D, Williams SK, Tontz W, Chen AC, Sah RL, Bugbee WD. The effects of storage on fresh human osteochondral allografts. Clin Orthop Relat Res. 2004;418:246–252.PubMedCrossRef

Bayne O, Langer F, Pritzker KP, Houpt J, Gross AE. Osteochondral allografts in the treatment of osteonecrosis of the knee. Orthop Clin North Am. 1985;16:727–740.PubMed

Beaver RJ, Mahomed M, Backstein D, Davis A, Zukor DJ, Gross AE. Fresh osteochondral allografts for post-traumatic defects in the knee. A survivorship analysis. J Bone Joint Surg Br. 1992;74:105–210.PubMed

10.

Borazjani BH, Chen AC, Bae WC, Patil S, Sah RL, Firestein GS, Bugbee WD. Effect of impact on chondrocyte viability during insertion of human osteochondral grafts. J Bone Joint Surg Am. 2006;88:1934–1943.PubMedCrossRef

11.

Bugbee WD, Convery FR. Osteochondral allograft transplantation. Clin Sports Med. 1999;18:67–75.PubMedCrossRef

12.

Chen AC, Bae WC, Schinagl RM, Sah RL. Depth- and strain-dependent mechanical and electromechanical properties of full-thickness bovine articular cartilage in confined compression. J Biomech. 2001;34:1–12.PubMedCrossRef

13.

Chen CT, Bhargava M, Lin PM, Torzilli PA. Time, stress, and location dependent chondrocyte death and collagen damage in cyclically loaded articular cartilage. J Orthop Res. 2003;21:888–898.PubMedCrossRef

14.

Chen CT, Fishbein KW, Torzilli PA, Hilger A, Spencer RG, Horton WE Jr. Matrix fixed-charge density as determined by magnetic resonance microscopy of bioreactor-derived hyaline cartilage correlates with biochemical and biomechanical properties. Arthritis Rheum. 2003;48:1047–1056.PubMedCrossRef

15.

Chu CR, Coutts RD, Yoshioka M, Harwood FL, Monosov AZ, Amiel D. Articular cartilage repair using allogeneic perichondrocyte-seeded biodegradable porous polylactic acid (PLA): a tissue-engineering study. J Biomed Mater Res. 1995;29:1147–1154.PubMedCrossRef

16.

Convery FR, Akeson WH, Amiel D, Meyers MH, Monosov A. Long-term survival of chondrocytes in an osteochondral articular cartilage allograft. A case report. J Bone Joint Surg Am. 1996;78:1082–1088.PubMed

17.

Convery FR, Botte MJ, Akeson WH, Meyers MH. Chondral defects of the knee. Contemp Orthop. 1994;28:101–107.PubMed

18.

Convery FR, Meyers MH, Akeson WH. Fresh osteochondral allografting of the femoral condyle. Clin Orthop Relat Res. 1991;273:139–245.PubMed

19.

Curl WW, Krome J, Gordon ES, Rushing J, Smith BP, Poehling GG. Cartilage injuries: a review of 31,516 knee arthroscopies. Arthroscopy. 1997;13:456–460.PubMed

20.

Custers RJ, Creemers LB, Verbout AJ, van Rijen MH, Dhert WJ, Saris DB. Reliability, reproducibility and variability of the traditional Histologic/Histochemical Grading System vs the new OARSI Osteoarthritis Cartilage Histopathology Assessment System. Osteoarthritis Cartilage. 2007;15:1241–1248.PubMedCrossRef

21.

Czitrom AA, Keating S, Gross AE. The viability of articular cartilage in fresh osteochondral allografts after clinical transplantation. J Bone Joint Surg Am. 1990;72:574–581.PubMed

22.

Davidson PA, Rivenburgh DW, Dawson PE, Rozin R. Clinical, histologic, and radiographic outcomes of distal femoral resurfacing with hypothermically stored osteoarticular allografts. Am J Sports Med. 2007;35:1082–1090.PubMedCrossRef

23.

Emmerson BC, Gortz S, Jamali AA, Chung C, Amiel D, Bugbee WD. Fresh osteochondral allografting in the treatment of osteochondritis dissecans of the femoral condyle. Am J Sports Med. 2007;35:907–914.PubMedCrossRef

24.

Enneking WF, Campanacci DA. Retrieved human allografts: a clinicopathological study. J Bone Joint Surg Am. 2001;83:971.PubMed

25.

Enneking WF, Mindell ER. Observations on massive retrieved human allografts. J Bone Joint Surg Am. 1991;73:1123–1142.PubMed

26.

Farmer JM, Martin DF, Boles CA, Curl WW. Chondral and osteochondral injuries. Diagnosis and management. Clin Sports Med. 2001;20:299–320.PubMedCrossRef

27.

Fitzpatrick PL, Morgan DA. Fresh osteochondral allografts: a 6–10-year review. Aust N Z J Surg. 1998;68:573–579.PubMedCrossRef

28.

Friedlaender GE, Mankin HJ. Transplantation of osteochondral allografts. Annu Rev Med. 1984;35:311–324.PubMedCrossRef

29.

Friedlaender GE, Strong DM, Tomford WW, Mankin HJ. Long-term follow-up of patients with osteochondral allografts. A correlation between immunologic responses and clinical outcome. Orthop Clin North Am. 1999;30:583–588.PubMedCrossRef

30.

Garrett JC. Fresh osteochondral allografts for treatment of articular defects in osteochondritis dissecans of the lateral femoral condyle in adults. Clin Orthop Relat Res. 1994;303:33–47.PubMed

31.

Goldring MB, Goldring SR. Osteoarthritis. J Cell Physiol. 2007;213:626–634.PubMedCrossRef

32.

Gole MD, Poulsen D, Marzo JM, Ko SH, Ziv I. Chondrocyte viability in press-fit cryopreserved osteochondral allografts. J Orthop Res. 2004;22:781–787.PubMedCrossRef

33.

Gortz S, Bugbee WD. Allografts in articular cartilage repair. Instr Course Lect. 2007;56:469–580.PubMed

34.

Gross AE, Aubin P, Cheah HK, Davis AM, Ghazavi MT. A fresh osteochondral allograft alternative. J Arthroplasty. 2002;17(Suppl 1):50–53.PubMedCrossRef

35.

Gross AE, McKee NH, Pritzker KP, Langer F. Reconstruction of skeletal deficits at the knee. A comprehensive osteochondral transplant program. Clin Orthop Relat Res. 1983;174:96–106.PubMed

36.

Gross AE, Shasha N, Aubin P. Long-term followup of the use of fresh osteochondral allografts for posttraumatic knee defects. Clin Orthop Relat Res. 2005;435:79–87.PubMedCrossRef

37.

Haugland R. Molecular probes. In: Handbook of Fluorescent Probes, Research Chemicals. Eugene, OR: Molecular Probes Inc; 1994:422.

38.

Hurtig MB, Novak K, McPherson R, McFadden S, McGann LE, Muldrew K, Schachar NS. Osteochondral dowel transplantation for repair of focal defects in the knee: an outcome study using an ovine model. Vet Surg. 1998;27:5–16.PubMedCrossRef

39.

Jacobs NJ. Establishing a surgical bone bank. In: Fawcett K, Barr HR, eds. Tissue Banking. Arlington, VA: American Association of Blood Banks; 1987:67–96.

40.

Levin A, Burton-Wurster N, Chen CT, Lust G. Intercellular signaling as a cause of cell death in cyclically impacted cartilage explants. Osteoarthritis Cartilage. 2001;9:702–711.PubMedCrossRef

41.

Lightfoot A, Martin J, Amendola A. Fluorescent viability stains overestimate chondrocyte viability in osteoarticular allografts. Am J Sports Med. 2007;35:1817–1823.PubMedCrossRef

42.

Malinin T, Temple HT, Buck BE. Transplantation of osteochondral allografts after cold storage. J Bone Joint Surg Am. 2006;88:762–770.PubMedCrossRef

43.

Marco F, Lopez-Oliva F, Fernández Fernández-Arroyo JM, de Pedro JA, Perez AJ, Leon C, Lopez-Duran L. Osteochondral allografts for osteochondritis dissecans and osteonecrosis of the femoral condyles. Int Orthop. 1993;17:104–108.PubMedCrossRef

44.

Maury AC, Safir O, Heras FL, Pritzker KP, Gross AE. Twenty-five-year chondrocyte viability in fresh osteochondral allograft. A case report. J Bone Joint Surg Am. 2007;89:159–165.PubMedCrossRef

45.

McCulloch PC, Kang RW, Sobhy MH, Hayden JK, Cole BJ. Prospective evaluation of prolonged fresh osteochondral allograft transplantation of the femoral condyle: minimum 2-year follow-up. Am J Sports Med. 2007;35:411–420.PubMedCrossRef

46.

McDermott AG, Langer F, Pritzker KP, Gross AE. Fresh small fragment osteochondral allografts: long-term followup study on first 100 cases. Clin Orthop Relat Res. 1985;197:96–102.PubMed

47.

McGovern BM, Pritzker KP, Shasha N, Price J, Gross AE. Long-term chondrocyte viability in fresh osteochondral allograft. Am J Knee Surg. 2002;15:97–100.

48.

Meyers MH, Akeson W, Convery FR. Resurfacing of the knee with fresh osteochondral allograft. J Bone Joint Surg Am. 1989;71:704–713.PubMed

49.

Muldrew K, Hurtig M, Novak K, Schachar N, McGann LE. Localization of freezing injury in articular cartilage. Cryobiology. 1994;31:31–38.PubMedCrossRef

50.

Ohlendorf C, Tomford WW, Mankin HJ. Chondrocyte survival in cryopreserved osteochondral articular cartilage. J Orthop Res. 1996;14:413–416.PubMedCrossRef

51.

Pearsall AW, Tucker JA, Hester RB, Heitman RJ. Chondrocyte viability in refrigerated osteochondral allografts used for transplantation within the knee. Am J Sports Med. 2004;32:125–231.PubMedCrossRef

52.

Pearson K, Dock N, Brubaker S. Standards for tissue banking. In: American Association of Tissue Banks. McClean, VA: American Association of Tissue Banks; 2008.

53.

Robertson CM, Allen RT, Pennock AT, Bugbee WD, Amiel D. Upregulation of apoptotic and matrix-related gene expression during fresh osteochondral allograft storage. Clin Orthop Relat Res. 2006;442:260–266.PubMedCrossRef

54.

Rohde RS, Studer RK, Chu CR. Mini-pig fresh osteochondral allografts deteriorate after 1 week of cold storage. Clin Orthop Relat Res. 2004;427:226–233.PubMedCrossRef

55.

Salai M, Ganel A, Horoszowski H. Fresh osteochondral allografts at the knee joint: good functional results in a follow-up study of more than 15 years. Arch Orthop Trauma Surg. 1997;116:423–425.PubMed

56.

Shelbourne KD, Jari S, Gray T. Outcome of untreated traumatic articular cartilage defects of the knee: a natural history study. J Bone Joint Surg Am. 2003;85(Suppl 2):8–16.PubMed

57.

Sirlin CB, Brossmann J, Boutin RD, Pathria MN, Convery FR, Bugbee W, Deutsch R, Lebeck LK, Resnick D. Shell osteochondral allografts of the knee: comparison of MR imaging findings and immunologic responses. Radiology. 2001;219:35–43.PubMed

58.

Szomor ZL, Martin TE, Bonar F, Murrell GA. The protective effects of meniscal transplantation on cartilage. An experimental study in sheep. J Bone Joint Surg Am. 2000;82:80–88.PubMed

59.

Tomford WW, Springfield DS, Mankin HJ. Fresh and frozen articular cartilage allografts. Orthopedics. 1992;15:1183.PubMed

60.

Torzilli P. Measurement of the compressive properties of thin cartilage slices: evaluating tissue in homogeneity. In: Maroudas A, ed. Cartilage Methods. New York, NY: Academic Press; 1990:304–308.

61.

Torzilli PA, Grigiene R, Huang C, Friedman SM, Doty SB, Boskey AL, Lust G. Characterization of cartilage metabolic response to static and dynamic stress using a mechanical explant test system. J Biomech. 1997;30:1–9.PubMedCrossRef

62.

Wayne JS, Amiel D, Kwan MK, Woo SL, Fierer A, Meyers MH. Long-term storage effects on canine osteochondral allografts. Acta Orthop Scand. 1990;61:539–545.PubMedCrossRef

63.

Williams JM, Virdi AS, Pylawka TK, Edwards RB, Markel MD, Cole BJ. Prolonged-fresh preservation of intact whole canine femoral condyles for the potential use as osteochondral allografts. J Orthop Res. 2005;23:831–837.PubMedCrossRef

64.

Williams RJ, Ranawat AS, Potter HG, Carter T, Warren RF. Fresh stored allografts for the treatment of osteochondral defects of the knee. J Bone Joint Surg Am. 2007;89:718–726.PubMedCrossRef

65.

Williams RJ 3rd, Dreese JC, Chen CT. Chondrocyte survival and material properties of hypothermically stored cartilage: an evaluation of tissue used for osteochondral allograft transplantation. Am J Sports Med. 2004;32:132–139.PubMedCrossRef

66.

Williams S, Amiel D, Ball S, Allen RT, Wong VW, Chen AC, Sah RL, Bugbee WD. Prolonged storage effects on the articular cartilage of fresh human osteochondral allografts. J Bone Joint Surg Am. 2003;85:2111–2120.PubMed

67.

Williams SK, Amiel D, Ball ST, Allen RT, Tontz WL Jr, Emmerson BC, Badlani NM, Emery SC, Haghighi P, Bugbee WD. Analysis of cartilage tissue on a cellular level in fresh osteochondral allograft retrievals. Am J Sports Med. 2007;35:2022–2032.PubMedCrossRef

Title: Material Properties of Fresh Cold-stored Allografts for Osteochondral Defects at 1 Year
Authors: Anil S. Ranawat, MD
Armando F. Vidal, MD
Chris T. Chen, PhD
Jonathan A. Zelken, BA
A. Simon Turner, BVSc
Riley J. Williams III, MD
Publication date: 01-08-2008
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 8/2008
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-008-0311-7

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Springer Medicine

Material Properties of Fresh Cold-stored Allografts for Osteochondral Defects at 1 Year

Abstract

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Springer Medicine

Abstract

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