Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 12/2013

01-12-2013 | Knee

Total femoral and tibial osteochondral allograft for remobilizing a knee after arthrodesis

Authors: Sandro Giannini, Roberto Buda, Alberto Ruffilli, Gherardo Pagliazzi, Francesca Vannini

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 12/2013

Login to get access

Abstract

Purpose

Knee arthrodesis is a scarcely tolerated procedure with a strong negative impact on the quality of life of the patient. The use of a fresh osteochondral allograft represents a fascinating option for a biological joint reconstruction. Aim of this report is to describe a case of total femoral and tibial osteochondral allograft used for reversing a non-tolerated knee fusion in a young patient and to report the clinical and radiographic results obtained at a 4-year follow-up.

Methods

A 22-year-old man with right knee arthrodesis received a reversion of the arthrodesis with a total femoral and tibial osteochondral allograft. Clinical and radiographical evaluations were carried out periodically up to 48 months.

Results

At 48 months of follow-up, the patient had full integration of the allograft with a range of motion from 0° to 80°. Clinical scores improved from preoperative to final follow-up (IKDC from 25 to 65, KOOS from 32 to 65 and WOMAC from 30 to 74). Radiographic arthritis occurrence of the transplanted surfaces was evident at follow-up.

Conclusions

Despite the good clinical results achieved in the case described, a wider applicability of total femoral and tibial osteochondral allograft requires further studies on long-term larger allograft survival. Arthritis recurrence of the transplanted surfaces is cause of concern. Causes and possible solutions need to be more deeply investigated.

Level of evidence

Case report, Level V.
Literature
1.
go back to reference Aubin PP, Cheah HK, Davis AM, Gross AE (2001) Long-term follow-up of fresh femoral osteochondral allografts for posttraumatic knee defects. Clin Orthop Relat Res 391(Suppl):S318–S327PubMedCrossRef Aubin PP, Cheah HK, Davis AM, Gross AE (2001) Long-term follow-up of fresh femoral osteochondral allografts for posttraumatic knee defects. Clin Orthop Relat Res 391(Suppl):S318–S327PubMedCrossRef
2.
go back to reference Beaver RJ, Mahomed M, Backstein D, Davis A, Zukor DJ, Gross AE (1992) Fresh osteochondral allografts for post-traumatic defects in the knee. A survivorship analysis. J Bone Joint Surg Br 74:105–110PubMed Beaver RJ, Mahomed M, Backstein D, Davis A, Zukor DJ, Gross AE (1992) Fresh osteochondral allografts for post-traumatic defects in the knee. A survivorship analysis. J Bone Joint Surg Br 74:105–110PubMed
3.
4.
go back to reference Cameron HU, Hu C (1996) Results of total knee arthroplasty following takedown of formal knee fusion. J Arthroplasty 11:732–737PubMedCrossRef Cameron HU, Hu C (1996) Results of total knee arthroplasty following takedown of formal knee fusion. J Arthroplasty 11:732–737PubMedCrossRef
5.
go back to reference Cho SH, Jeong ST, Park HB, Hwang SC, Kim DH (2008) Two-stage conversion of fused knee to total knee arthroplasty. J Arthroplasty 23:476–479PubMedCrossRef Cho SH, Jeong ST, Park HB, Hwang SC, Kim DH (2008) Two-stage conversion of fused knee to total knee arthroplasty. J Arthroplasty 23:476–479PubMedCrossRef
6.
go back to reference Chu CR, Convery FR, Akeson WH, Meyers M, Amiel D (1999) Articular cartilage transplantation. Clinical results in the knee. Clin Orthop Relat Res 360:159–168PubMedCrossRef Chu CR, Convery FR, Akeson WH, Meyers M, Amiel D (1999) Articular cartilage transplantation. Clinical results in the knee. Clin Orthop Relat Res 360:159–168PubMedCrossRef
7.
go back to reference Clemens D, Lereim P, Holm I, Reikerås O (2005) Conversion of knee fusion to total arthroplasty: complications in 8 patients. Acta Orthop 76:370–374PubMed Clemens D, Lereim P, Holm I, Reikerås O (2005) Conversion of knee fusion to total arthroplasty: complications in 8 patients. Acta Orthop 76:370–374PubMed
8.
go back to reference Convery FR, Meyers MH, Akeson WH (1991) Fresh osteochondral allografting of the femoral condyle. Clin Orthop Relat Res 273:139–145PubMed Convery FR, Meyers MH, Akeson WH (1991) Fresh osteochondral allografting of the femoral condyle. Clin Orthop Relat Res 273:139–145PubMed
9.
go back to reference Czitrom AA, Keating S, Gross AE (1990) The viability of articular cartilage in fresh osteochondral allografts after clinical transplantation. J Bone Joint Surg Am 72:574–581PubMed Czitrom AA, Keating S, Gross AE (1990) The viability of articular cartilage in fresh osteochondral allografts after clinical transplantation. J Bone Joint Surg Am 72:574–581PubMed
10.
go back to reference Dejour H, Walch G, Nove-Josserand L, Guier C (1994) Factors of patellar instability: an anatomic radiographic study. Knee Surg Sports Traumatol Arthrosc 2:19–26PubMedCrossRef Dejour H, Walch G, Nove-Josserand L, Guier C (1994) Factors of patellar instability: an anatomic radiographic study. Knee Surg Sports Traumatol Arthrosc 2:19–26PubMedCrossRef
11.
go back to reference Demir B, Oke R, Ozturk K, Aydin K, Gursu S, Sahin V (2008) Correction of a major flexion deformity developed after knee arthrodesis in child age: a case report. Acta Orthop Belg 74:424–428PubMed Demir B, Oke R, Ozturk K, Aydin K, Gursu S, Sahin V (2008) Correction of a major flexion deformity developed after knee arthrodesis in child age: a case report. Acta Orthop Belg 74:424–428PubMed
12.
go back to reference Garrett JC (1994) Fresh osteochondral allografts for treatment of articular defects in osteochondritis dissecans of the lateral femoral condyle in adults. Clin Orthop Relat Res 303:33–37PubMed Garrett JC (1994) Fresh osteochondral allografts for treatment of articular defects in osteochondritis dissecans of the lateral femoral condyle in adults. Clin Orthop Relat Res 303:33–37PubMed
13.
go back to reference Giannini S, Buda R, Grigolo B, Bevoni R, Di Caprio F, Ruffilli A, Cavallo M, Desando G, Vannini F (2010) Bipolar fresh osteochondral allograft of the ankle. Foot Ankle Int 31:38–46PubMedCrossRef Giannini S, Buda R, Grigolo B, Bevoni R, Di Caprio F, Ruffilli A, Cavallo M, Desando G, Vannini F (2010) Bipolar fresh osteochondral allograft of the ankle. Foot Ankle Int 31:38–46PubMedCrossRef
14.
go back to reference Giannini S, Buda R, Cavallo M, Ruffilli A, Grigolo B, Fornasari PM, Vannini F (2011) Bipolar fresh osteochondral allograft for the treatment of glenohumeral post-traumatic arthritis. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-011-1793-5 Giannini S, Buda R, Cavallo M, Ruffilli A, Grigolo B, Fornasari PM, Vannini F (2011) Bipolar fresh osteochondral allograft for the treatment of glenohumeral post-traumatic arthritis. Knee Surg Sports Traumatol Arthrosc. doi:10.​1007/​s00167-011-1793-5
15.
go back to reference Giannini S, Buda R, Cavallo M, Ruffilli A, Fornasari PM, Vannini F. Conversion of painful ankle arthrodesis to bipolar fresh osteochondral allograft: case report. Foot Ankle Int. 33:678–681 Giannini S, Buda R, Cavallo M, Ruffilli A, Fornasari PM, Vannini F. Conversion of painful ankle arthrodesis to bipolar fresh osteochondral allograft: case report. Foot Ankle Int. 33:678–681
16.
go back to reference Görtz S, Bugbee WD (2006) Allografts in articular cartilage repair. J Bone Joint Surg Am 88:1374–1384PubMed Görtz S, Bugbee WD (2006) Allografts in articular cartilage repair. J Bone Joint Surg Am 88:1374–1384PubMed
17.
go back to reference Gross AE, Silverstein EA, Falk J, Falk R, Langer F (1975) The allotransplantation of partial joints in the treatment of osteoarthritis of the knee. Clin Orthop Relat Res 108:7–14PubMedCrossRef Gross AE, Silverstein EA, Falk J, Falk R, Langer F (1975) The allotransplantation of partial joints in the treatment of osteoarthritis of the knee. Clin Orthop Relat Res 108:7–14PubMedCrossRef
18.
go back to reference Gross AE, Shasha N, Aubin P (2005) Long-term follow-up of the use of fresh osteochondral allografts for post traumatic knee defects. Clin Orthop Relat Res 435:79–87PubMedCrossRef Gross AE, Shasha N, Aubin P (2005) Long-term follow-up of the use of fresh osteochondral allografts for post traumatic knee defects. Clin Orthop Relat Res 435:79–87PubMedCrossRef
19.
go back to reference Henkel TR, Boldt JG, Drobny TK, Munzinger UK (2001) Total knee arthroplasty after formal knee fusion using unconstrained and semiconstrained components: a report of 7 cases. J Arthroplasty 16:768–776PubMedCrossRef Henkel TR, Boldt JG, Drobny TK, Munzinger UK (2001) Total knee arthroplasty after formal knee fusion using unconstrained and semiconstrained components: a report of 7 cases. J Arthroplasty 16:768–776PubMedCrossRef
20.
go back to reference Kim CW, Jamali A, Tontz W Jr, Convery FR, Brage ME, Bugbee W (2002) Treatment of post-traumatic ankle arthrosis with bipolar tibiotalar osteochondral shell allografts. Foot Ankle Int 23:1091–1102PubMed Kim CW, Jamali A, Tontz W Jr, Convery FR, Brage ME, Bugbee W (2002) Treatment of post-traumatic ankle arthrosis with bipolar tibiotalar osteochondral shell allografts. Foot Ankle Int 23:1091–1102PubMed
21.
go back to reference Kim YH, Kim JS, Cho SH (2000) Total knee arthroplasty after spontaneous osseous ankylosis and takedown of formal knee fusion. J Arthroplasty 15:453–460PubMedCrossRef Kim YH, Kim JS, Cho SH (2000) Total knee arthroplasty after spontaneous osseous ankylosis and takedown of formal knee fusion. J Arthroplasty 15:453–460PubMedCrossRef
22.
go back to reference Kim YH, Oh SH, Kim JS (2003) Conversion of a fused knee with use of a posterior stabilized total knee prosthesis. J Bone Joint Surg Am 85:1047–1050PubMedCrossRef Kim YH, Oh SH, Kim JS (2003) Conversion of a fused knee with use of a posterior stabilized total knee prosthesis. J Bone Joint Surg Am 85:1047–1050PubMedCrossRef
23.
go back to reference Langer F, Czitrom A, Pritzker KP, Gross AE (1975) The immunogenicity of fresh and frozen allogeneic bone. J Bone Joint Surg Am 57:216–220PubMed Langer F, Czitrom A, Pritzker KP, Gross AE (1975) The immunogenicity of fresh and frozen allogeneic bone. J Bone Joint Surg Am 57:216–220PubMed
24.
go back to reference MacDonald JH, Agarwal S, Lorei MP, Johanson NA, Freiberg AA (2006) Knee arthrodesis. J Am Acad Orthop Surg 14:154–163PubMed MacDonald JH, Agarwal S, Lorei MP, Johanson NA, Freiberg AA (2006) Knee arthrodesis. J Am Acad Orthop Surg 14:154–163PubMed
25.
go back to reference Mahomed MN, Beaver RJ, Gross AE (1992) The long-term success of fresh, small fragment osteochondral allografts used for intraarticular post-traumatic defects in the knee joint. Orthopedics 15:1191–1199PubMed Mahomed MN, Beaver RJ, Gross AE (1992) The long-term success of fresh, small fragment osteochondral allografts used for intraarticular post-traumatic defects in the knee joint. Orthopedics 15:1191–1199PubMed
26.
go back to reference Naranja RJ, Lotke PA, Pagnano MW (1996) Total knee arthroplasty in a previously ankylosed or arthrodesed knee. Clin Orthop Relat Res 331:234–237PubMedCrossRef Naranja RJ, Lotke PA, Pagnano MW (1996) Total knee arthroplasty in a previously ankylosed or arthrodesed knee. Clin Orthop Relat Res 331:234–237PubMedCrossRef
27.
go back to reference Torga Spak R, Teitge RA (2006) Fresh osteochondral allografts for patellofemoral arthritis: long-term followup. Clin Orthop Relat Res 444:193–200PubMedCrossRef Torga Spak R, Teitge RA (2006) Fresh osteochondral allografts for patellofemoral arthritis: long-term followup. Clin Orthop Relat Res 444:193–200PubMedCrossRef
Metadata
Title
Total femoral and tibial osteochondral allograft for remobilizing a knee after arthrodesis
Authors
Sandro Giannini
Roberto Buda
Alberto Ruffilli
Gherardo Pagliazzi
Francesca Vannini
Publication date
01-12-2013
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 12/2013
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-012-2214-0

Other articles of this Issue 12/2013

Knee Surgery, Sports Traumatology, Arthroscopy 12/2013 Go to the issue