Failures in bipolar fresh osteochondral allograft for the treatment of end-stage knee osteoarthritis

Verfasser / Beitragende:
[S. Giannini, R. Buda, A. Ruffilli, G. Pagliazzi, A. Ensini, B. Grigolo, G. Desando, F. Vannini]
Ort, Verlag, Jahr:
2015
Enthalten in:
Knee Surgery, Sports Traumatology, Arthroscopy, 23/7(2015-07-01), 2081-2089
Format:
Artikel (online)
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024 7 0 |a 10.1007/s00167-014-2961-1  |2 doi 
035 |a (NATIONALLICENCE)springer-10.1007/s00167-014-2961-1 
245 0 0 |a Failures in bipolar fresh osteochondral allograft for the treatment of end-stage knee osteoarthritis  |h [Elektronische Daten]  |c [S. Giannini, R. Buda, A. Ruffilli, G. Pagliazzi, A. Ensini, B. Grigolo, G. Desando, F. Vannini] 
520 3 |a Purpose: Bipolar fresh osteochondral allografts (BFOA) recently became a fascinating option for articular cartilage replacement, in particular in those young patients non-suitable for traditional replacement because of age. While the use of osteochondral allografts for the treatment of focal osteochondral lesions in the knee is well established, their use in the treatment of end-stage arthritis is far more controversial. The purpose of this paper is to describe our experience in a series of seven patients who underwent a resurfacing of both tibio-femoral and patello-femoral joints by BFOA. Methods: From 2005 to 2007, seven patients (mean age 35.2±6.3years) underwent BFOA for end-stage arthritis of the knee. Patients were evaluated clinically, radiographically and by CT scan preoperatively and at established intervals up to the final follow-up. Results: No intra-operative complications occurred. Nevertheless, joint laxity and aseptic effusion, along with a progressive chondrolysis, lead to early BFOA failure in six patients, which were revised by total knee arthroplasty at 19.5±3.9months follow-up. Only one patient, who received the allograft to convert a knee arthrodesis, gained a satisfactory result at the last follow-up control. Conclusions: BFOA in the knee joint still remains an inapplicable option in the treatment of post-traumatic end-stage arthritis of the young patient, due to the high rate of failure. Further studies are necessary in order to investigate the causes of failure and improve the applicability of this method. Still, after extensive counselling with the patient, BFOA may represent a salvage procedure aimed to revise scarcely tolerated knee arthrodesis. Level of evidence: Retrospective case series, Level IV. 
540 |a Springer-Verlag Berlin Heidelberg, 2014 
690 7 |a Knee  |2 nationallicence 
690 7 |a Osteochondral allograft  |2 nationallicence 
690 7 |a Replacement  |2 nationallicence 
690 7 |a Osteoarthritis  |2 nationallicence 
690 7 |a Young patients  |2 nationallicence 
700 1 |a Giannini  |D S.  |u I Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna University, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy  |4 aut 
700 1 |a Buda  |D R.  |u I Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna University, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy  |4 aut 
700 1 |a Ruffilli  |D A.  |u I Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna University, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy  |4 aut 
700 1 |a Pagliazzi  |D G.  |u I Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna University, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy  |4 aut 
700 1 |a Ensini  |D A.  |u I Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna University, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy  |4 aut 
700 1 |a Grigolo  |D B.  |u Laboratory of Immunorheumatology and Tissue Regeneration, Rizzoli Orthopaedic Institute, 40136, Bologna, Italy  |4 aut 
700 1 |a Desando  |D G.  |u Laboratory of Immunorheumatology and Tissue Regeneration, Rizzoli Orthopaedic Institute, 40136, Bologna, Italy  |4 aut 
700 1 |a Vannini  |D F.  |u I Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna University, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy  |4 aut 
773 0 |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/7(2015-07-01), 2081-2089  |x 0942-2056  |q 23:7<2081  |1 2015  |2 23  |o 167 
856 4 0 |u https://doi.org/10.1007/s00167-014-2961-1  |q text/html  |z Onlinezugriff via DOI 
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950 |B NATIONALLICENCE  |P 856  |E 40  |u https://doi.org/10.1007/s00167-014-2961-1  |q text/html  |z Onlinezugriff via DOI 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Giannini  |D S.  |u I Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna University, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Buda  |D R.  |u I Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna University, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Ruffilli  |D A.  |u I Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna University, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Pagliazzi  |D G.  |u I Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna University, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Ensini  |D A.  |u I Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna University, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Grigolo  |D B.  |u Laboratory of Immunorheumatology and Tissue Regeneration, Rizzoli Orthopaedic Institute, 40136, Bologna, Italy  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Desando  |D G.  |u Laboratory of Immunorheumatology and Tissue Regeneration, Rizzoli Orthopaedic Institute, 40136, Bologna, Italy  |4 aut 
950 |B NATIONALLICENCE  |P 700  |E 1-  |a Vannini  |D F.  |u I Clinic of Orthopaedics and Traumatology, Rizzoli Orthopaedic Institute, Bologna University, Via Giulio Cesare Pupilli 1, 40136, Bologna, Italy  |4 aut 
950 |B NATIONALLICENCE  |P 773  |E 0-  |t Knee Surgery, Sports Traumatology, Arthroscopy  |d Springer Berlin Heidelberg  |g 23/7(2015-07-01), 2081-2089  |x 0942-2056  |q 23:7<2081  |1 2015  |2 23  |o 167