Cartilage repair and regeneration: The role of allografts in the treatment of chondral and osteochondral lesions

There is no clear treatment approach that reliably yields successful clinical outcomes in young patients with cartilage lesions of the knee. Allograft osteochondral transplantation is one of many treatment options. The isolated full thickness chondral or osteochondral lesion is most suitable to this treatment strategy. The surgical technique involves reconstructing the damaged articular surface with a composite of viable allograft hyaline cartilage anchored to subchondral bone. Osseous incorporation of the allograft to host bone is critical for successful long-term results. Limb malalignment, bipolar lesions, and location of the lesion can adversely affect surgical outcome. In the proper patient, using good surgical technique, success rates of up to 85% may be expected when using fresh grafts. Preserved grafts have recently become more available due to advances in graft storage techniques. However, there is insufficient data on the use of frozen, cryopreserved, and cold-stored grafts to make a conclusion on their long-term success.