FRESH OSTEOCHONDRAL ALLOGRAFTS AT THE KNEE-JOINT - GOOD FUNCTIONAL RESULTS IN A FOLLOW-UP-STUDY OF MORE THAN 15 YEARS

The treatment of deep chondral defects at the knee joint poses major d ifficulties and challenges to the orthopaedic surgeon, particularly in young patients for whom solutions like total or hemi-joint arthroplas ty are not recommended, because of their limited durability. Biologica l resurfacing with materials such as perichondrium, periosteal allogra fts, and cultured chondrocytes is still at the experimental stage and there has been limited clinical validation. Since 1978, we have succes sfully used fresh osteochondral ('shell') allografts for the treatment of selected patients with a chondral defect at the knee joint. These grafts, implanted mainly in young patients, have proved durable and ha ve provided good functional results for more than 15 years, as shown b y an average of 84.6 in the Hospital for Special Surgery (HSS) Knee Sc ore. The operative technique and results of long-term follow-up of pat ients receiving fresh, osteochondral ('shell') allografts are presente d and discussed.