Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Fresh osteochondral allografts at the knee joint: good functional results in a follow-up study of more than 15 years

  • 64 Accesses

  • 20 Citations


The treatment of deep chondral defects at the knee joint poses major difficulties and challenges to the orthopaedic surgeon, particularly in young patients for whom solutions like total or hemi-joint arthroplasty are not recommended, because of their limited durability. Biological resurfacing with materials such as perichondrium, periosteal allografts, and cultured chondrocytes is still at the experimental stage and there has been limited clinical validation. Since 1978, we have successfully 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 have provided good functional results for more than 15 years, as shown by an average of 84.6 in the Hospital for Special Surgery (HSS) Knee Score. The operative technique and results of long-term follow-up of patients receiving fresh, osteochondral (‘shell’) allografts are presented and discussed.

This is a preview of subscription content, log in to check access.


  1. 1.

    Amiel D, Courts RD, Abel M et al (1985) Rib perichondrial grafts for the repair of full-thickness articular-cartilage defects: a morphological and biochemical study in rabbits. J Bone Joint Surg [Am] 67:911–920

  2. 2.

    Aston JE, Bentley G (1986) Repair of articular surfaces by allografts of articular and growth-plate cartilage. J Bone Joint Surg [Br] 68:29–35

  3. 3.

    Dahlberg L, Kreichergs A (1991) Demineralized allogeneic bone matrix for cartilage repair. J Orthop Res 9:9–11

  4. 4.

    Ganel A, Horoszowski H, Farin I (1979) Allograft joint transplantation. (Letter to the Editor) Clin Orthop 141:307

  5. 5.

    Ganel A, Israeli I, Horoszowski H, Farin I (1981) Osteochondral graft in the treatment of osteonecrosis of the femoral condyle. Am J Geriatr Soc 29:186–188

  6. 6.

    Garret J (1986) Treatment of osteochondral defects of the distal femur with fresh osteochondral allografts: a preliminary report. J Arthrosc 2:222–226

  7. 7.

    Gross AE, Silverstein EA, Falk J et al (1975) The allotransplantation of partial joints in the treatment of osteoarthritis of the knee. Clin Orthop 108:7

  8. 8.

    Gross AE, McKee NH, Pritzker KPH, Langer F (1983) Reconstruction of skeletal deficits at the knee. Clin Orthop 174:96–106

  9. 9.

    Itay S, Abramovici A, Nevo Z (1987) Use of cultured embryonal chick epiphyseal chondrocytes as grafts for defects in chick articular cartilage. Clin Orthop 220:284–303

  10. 10.

    Langer F, Gross AE, West U et al (1978) The immunogenicity of allograft knee joint transplants. Clin Orthop 132:155

  11. 11.

    Mankin HJ (1982) The response of articular cartilage to mechanical injury. J Bone Joint Surg [Am] 64:460–464

  12. 12.

    Mankin HJ, Doppelt S, Tomford WW (1983) Clinical experience with allograft implantation. Clin Orthop 174:69–86

  13. 13.

    O'Driscoll SW, Salter RB (1986) The repair of major osteochondral defects in joint surfaces by neochondrogenesis with autogenous osteoperiosteal grafts stimulated by continuous passive motion: an experimental investigation in the rabbit. Clin Orthop 208:131–140

  14. 14.

    Shahgaldi BF, Amis AA, Heatley FW, McDowell J, Bentley G (1991) Repair of cartilage lesions using biological implants: a comparative histological and biochemical study in goats. J Bone Joint Surg [Br] 73:57–64

  15. 15.

    Speer DP, Chvapil M, Volz RG, Holmes MD (1979) Enhancement of healing in osteochondral defects by collagen sponge implants. Clin Orthop 144:326–335

  16. 16.

    Takahashi S, Oka M, Kotoura AM, Yamamuro T (1995) Autogenous callo-osseous grafts for the repair of osteochondral defects. J Bone Joint Surg [Br] 77:200–204

  17. 17.

    Wakitani S, Kimura T, Hirooka A et al (1989) Repair of rabbit articular surfaces with allograft chondrocytes embedded in collagen gel. J Bone Joint Surg [Br] 71:74–80

Download references

Author information

Correspondence to M. Salai.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Salai, M., Ganel, A. & Horoszowski, H. Fresh osteochondral allografts at the knee joint: good functional results in a follow-up study of more than 15 years. Arch Orthop Trauma Surg 116, 423–425 (1997). https://doi.org/10.1007/BF00434005

Download citation


  • Public Health
  • Young Patient
  • Functional Result
  • Knee Joint
  • Operative Technique