Bugbee William, Cavallo Marco, Giannini Sandro
Division of Orthopaedic Surgery, Scripps Clinic, La Jolla, CA 92037, USA.
J Knee Surg. 2012 May;25(2):109-16. doi: 10.1055/s-0032-1313743.
Fresh osteochondral allograft (OCA) transplantation has over a 100-year clinical history. Many clinical and basic scientific studies have been performed with the result that allografting is now a part of the "cartilage repair paradigm" for the treatment of chondral or osteochondral lesions. In the knee joint, allografting has also been successfully used in complex joint reconstruction for the treatment of osteonecrosis, fracture malunion, and selected cases of osteoarthritis. Unlike many other cartilage repair techniques, OCA have the ability to restore mature, hyaline articular cartilage to the affected area. By virtue of their composite structure (cartilage and bone), allografts also can restore diseased or damaged bone often present in large or complex lesions. Nevertheless, OCA present unique and important difficulties in their clinical application, such as allograft tissue availability, safety issues, and immunologic response to the graft. Ongoing investigations continue to clarify the indications, surgical techniques, and clinical outcomes of fresh OCA.
新鲜骨软骨异体移植（OCA）已有100多年的临床历史。已经开展了许多临床和基础科学研究，结果是异体移植现已成为治疗软骨或骨软骨损伤的“软骨修复模式”的一部分。在膝关节中，异体移植也已成功用于复杂关节重建，以治疗骨坏死、骨折畸形愈合和某些骨关节炎病例。与许多其他软骨修复技术不同，OCA能够将成熟的透明关节软骨恢复到受影响区域。由于其复合结构（软骨和骨），异体移植还可以修复大的或复杂病变中常出现的患病或受损骨骼。然而，OCA在其临床应用中存在独特且重要的困难，例如异体移植组织的可用性、安全问题以及对移植物的免疫反应。正在进行的研究继续阐明新鲜OCA的适应证、手术技术和临床结果。
