PubMed · 7028361
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N H Antia, B M Daver. 1981. Reconstructive surgery for nasal defects.. https://pubmed.ncbi.nlm.nih.gov/7028361/
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UNLABELLED: It is well known that the capacity of articular cartilage for repair is limited. There have been many attempts to address this problem. However, treatment options are limited and the long-term outcome is uncertain. This article will focus on the osteochondral autograft transplantation (OAT), which is currently the only surgical cartilage repair technique that provides and retains proper hyaline articular cartilage. Osteochondral autograft transplants have been associated with a good rate of success, but further long-term follow-up and biomechanical evaluation are essential. LIMITATIONS: size and depth of osteochondral defects, availability of donor autologous grafts, potential for damaging donor sites, the dead spaces between circular grafts and integration of donor and recipient hyaline cartilage.
Experience with fresh osteochondral allografting for cartilage defects in the knee now extends two decades. Clinical outcomes and basic scientific investigations have supported the theoretic basis for this procedure. At the University of California, San Diego, our experience has encouraged us to continue to offer this procedure as a primary treatment for both large and small articular cartilage defects in the young knee. The success rate of fresh osteochondral allografting, particularly in isolated femoral condylar defects, compares favorably with other presently available cartilage repair and resurfacing techniques. In our second hundred cases, which we are currently evaluating, failure of monopolar allografts has been exceedingly rare in short-term follow-up. Fresh osteochondral allografting also appears to be effective in treating larger osteochondral lesions, where there are few other attractive alternatives. Fresh osteochondral allografts can thus be used to treat a wide spectrum of articular pathology. Technical refinements, and improvement in our understanding of graft-host interaction, as well as chondrocyte biology, should continue to improve clinical results. Disadvantages of fresh osteochondral allografting include the relative paucity of donor tissue, complexities in procurement and handling, and the possibility of disease transmission through the transplantation of fresh tissue. At present, only institutions that have overcome these obstacles seem capable of routinely performing this type of articular cartilage transplantation. In the future, as tissue banking and cartilage storage technology advance, fresh allograft tissue may become more available, allowing more widespread use of fresh osteochondral allografting in the treatment of articular cartilage lesions.
Monosegmental cervical spondylosis with radiculopathy requiring operative intervention responds well to anterior disc excision and fusion with autograft. However, there is a 20% to 25% morbidity from the donor site. Several new surgical techniques using biomechanical spacers or internal fixation have been developed that can be used with local bone or allograft, thus eliminating donor site morbidity. Surgical outcomes are comparable with those of traditional anterior cervical discectomy and fusion.