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Osteochondral Autograft Transfer Technique for Glenoid Osteochondral Defect.

ABSTRACT: Glenoid osteochondral defects can be a significant source of pain and disability in an active population. Many treatments are available, but most joint-preserving procedures are limited to debridement, abrasion chondroplasty, or marrow-stimulation techniques, all of which depend on healthy underlying bone and none of which address underlying bony pathology. Osteochondral autograft transfer has been a successful form of treatment for lesions in the knee, elbow, and ankle, especially when subchondral bone is involved. We describe an arthroscopic method of treating glenoid osteochondral lesions with an osteochondral autograft transfer using a graft from the patient's ipsilateral knee. This technique addresses both cartilage and osseous pathology with minimal morbidity and provides a good biological restorative option for patients with isolated glenoid osteochondral defects.

SUBMITTER: Wyland DJ

PROVIDER: S-EPMC5123990 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Reconstruction of a Central Full-Thickness Glenoid Defect Using Osteochondral Autograft Technique from the Ipsilateral Knee.

Project description:Background:Osteochondral defects (OCDs) of the shoulder represent a typical clinical problem and are difficult to manage. OCDs of the upper extremity are less common than those of the lower extremity. The incidence is reported to be between 5-17% in which the humerus is affected more frequently than the glenoid. OCD is often accompanied with symptoms and may appear secondary to trauma, instability or prior operation. The problem of the lesions is the missing blood circulation which makes the healing impossible. The hazard of OCDs is the progression to osteoarthritis. In spite of the effectiveness of total shoulder arthroplasty it is not the first option for young and active patients. The therapy options of OCD depend on the size and localization of the defect. Purpose:The aim of this multimedia article is to reveal a therapy option for OCDs of the glenoid. Methods:In this case we present the reconstruction of a central full-thickness osteochondral glenoid defect with an osteochondral autograft from the ipsilateral knee which was withdrawn using the OATS-Technique (Arthrex, Naples, Florida) to address the chondral as well as the osseous pathology. To the best of our knowledge there has been no such procedure performed and described so far. Results:The procedure lead to proper restoration of the defect. Conclusion:The demonstrated technique can be used to perform the reconstruction of a full-thickness osteochondral glenoid defect.

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Microstructural remodeling of articular cartilage following defect repair by osteochondral autograft transfer.

Project description:To assess collagen network alterations occurring with flow and other abnormalities of articular cartilage at medial femoral condyle (MFC) sites repaired with osteochondral autograft (OATS) after 6 and 12 months, using quantitative polarized light microscopy (qPLM) and other histopathological methods.The collagen network structure of articular cartilage of OATS-repaired defects and non-operated contralateral control sites were compared by qPLM analysis of parallelism index (PI), orientation angle (?) relative to the local tissue axes, and retardance (?) as a function of depth. qPLM parameter maps were also compared to ICRS and Modified O'Driscoll grades, and cell and matrix sub-scores, for sections stained with H&E and Safranin-O, and for Collagen-I and II.Relative to non-operated normal cartilage, OATS-repaired regions exhibited structural deterioration, with low PI and more horizontal ?, and unique structural alteration in adjacent host cartilage: more aligned superficial zone, and reoriented deep zone lateral to the graft, and matrix disorganization in cartilage overhanging the graft. Shifts in ? and PI from normal site-specific values were correlated with histochemical abnormalities and co-localized with changes in cell organization/orientation, cloning, or loss, indicative of cartilage flow, remodeling, and deterioration, respectively.qPLM reveals a number of unique localized alterations of the collagen network in both adjacent host and implanted cartilage in OATS-repaired defects, associated with abnormal chondrocyte organization. These alterations are consistent with mechanobiological processes and the direction and magnitude of cartilage strain.

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Project description:The Osteochondral Autograft Transfer System (OATS; Arthrex, Naples, FL) is an excellent option for the treatment of articular cartilage lesions within the knee. Current literature suggests that at early-term to midterm follow-up, patients experience improved function, alleviation of pain, and good satisfaction with acceptable complication rates. Although long-term data are lacking, studies in athletes have shown that the OATS can provide an adequate rate of return to sports. The OATS procedure has traditionally been considered an open procedure. However, with the advancement of arthroscopic techniques, the procedure can now be completed arthroscopically. We discuss this modern operation.

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All-Arthroscopic Osteochondral Autograft Transfer Technique for Osteochondritis Dissecans of the Talus.

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Cryopreserved, Viable Osteochondral Allograft for the Treatment of a Full-Thickness Cartilage Defect of the Glenoid.

Project description:Glenoid chondral injuries constitute challenging injuries to treat because of the limited access and the limited options and evidence available for their resolution. The purpose of this Technical Note is to describe the procedure, pearls, and pitfalls of implantation of a cryopreserved osteochondral allograft (Cartiform) for the treatment of full-thickness cartilage defects of the shoulder. Cartiform is a cryopreserved osteochondral allograft composed of chondrocytes, chondrogenic growth factors, and extracellular matrix proteins that can be implanted through a single-stage procedure.

| S-EPMC6306272 | biostudies-literature

Arthroscopic Osteochondral Autograft Transfer System Procedure of the Lateral Femoral Condyle with Donor-Site Backfill Using Osteochondral Allograft Plug.

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Project description: Not available

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