Osteochondral Allograft Transplantation:

Rehabilitation and Postoperative Management Practices After Osteochondral Allograft Transplants to the Distal Femur: A Report From the Metrics of Osteochondral Allografts (MOCA) Study Group 2016 Survey

Context:

We present the current spectrum of postoperative management practices for patients receiving distal femur osteochondral allograft (OCA) transplants.

Evidence Acquisition:

The Joint Restoration Foundation database was examined in cooperation with the Metrics of Osteochondral Allografts study group to identify 121 surgeons who had performed at least 1 OCA transplant in the past year; 63% of surgeons responded.

Study Design:

Clinical survey.

Level of Evidence:

Level 3.

Results:

Postoperative weightbearing restrictions ranged from immediate nonweightbearing with full weightbearing by 12 weeks to immediate weightbearing as tolerated. Most surgeons who performed fewer (<10) OCA transplants per year followed the most restrictive protocol, while surgeons who performed more (>20) OCA transplants per year followed the least restrictive protocol. One-third of surgeons with the most restrictive protocol were more likely to change their protocol to be less restrictive over time, while none of those with the least restrictive protocol changed their protocol over time. Fifty-five percent of surgeons permitted return to full activity at 26 weeks, while 27% of surgeons lifted restrictions at 16 weeks.

Conclusion:

Characterization of the spectrum of postoperative management practices after OCA transplantation provides a foundation for future investigations regarding patient outcomes and associated cost to establish best practice guidelines. Fundamentally, surgeons with more experience with this procedure tended to be more aggressive with their postoperative rehabilitation guidelines. Most commonly, rehabilitation provided for some degree of limited weightbearing; however, the spectrum also included immediate full weightbearing practices.

Effects of different preservation temperatures and periods menisci cellularity in rabbits

PURPOSE: Quantify the progressive decrease of the cellular viability of rabbit meniscus preserved for transplants over a 30 day period at different freezing temperatures. METHODS: 180 menisci were removed from 45 rabbits. Menisci were frozen from 2 to 30 days at -7.2°Celsius -21.4°Celsius and -73°Celsius. Four menisci from each temperature were thawed every two days and the number of present cells was quantified. RESULTS: On the 14th freezing day at -7.2°Celsius, there were 92.38% mean viable cells. However, as from the 16th day, there has been a significant 12% decrease (p = 0.001), as compared to 14th day mean. Mean cell viability at -21.4°Celsius and -73ºCelsius, until the 16th day was statistically similar. As from the 18th day at -21.4°Celsius, there has been significant cell count decrease (p < 0.001), especially from the 28th (54.5%) to the 30th (30%) freezing day. The number of viable cells at -73 0Celsius has shown insignificant 2.3% decrease (p = 1.000) from the 28th (40.2%) to the 30th (37.9%) day. CONCLUSION: The amount of viable meniscus cells is similar up to the 14th day of preservation, under any of the used temperatures. However, from the 14th day to the 30th day, the amount of viable cells is smaller in lower temperatures.