Journal of Cartilage & Joint Preservation最新文献

{"title":"Alternative irrigation fluids in orthopedics during critical times: lactated Ringer's and multielectrolytes solution maintain cartilage integrity similarly to normal saline—an in vitro osteochondral explant model","authors":"Chilan Bou Ghosson Leite ,&nbsp;Sebastian Schmidt ,&nbsp;Domenico Franco ,&nbsp;Cale A. Jacobs ,&nbsp;Christian Lattermann","doi":"10.1016/j.jcjp.2025.100247","DOIUrl":"10.1016/j.jcjp.2025.100247","url":null,"abstract":"<div><h3>Introduction</h3><div>Hurricane Helene in September 2024 disrupted saline distribution, causing a months-long shortage in US hospitals. Saline is essential for irrigation in orthopedic procedures, including arthroscopy. While alternatives such as lactated Ringer’s and multielectrolyte solutions have gained attention, evidence comparing their safety and efficacy to saline remains limited.</div></div><div><h3>Objectives</h3><div>To evaluate the effect of saline, lactated Ringer’s, and multielectrolytes solution on chondrocyte viability and extracellular matrix release in an in vitro osteochondral (OC) explant model.</div></div><div><h3>Methods</h3><div>OC explants (6<!--> <!-->×<!--> <!-->10<!--> <!-->mm) were harvested from OC allograft remnants and tested with saline, lactated Ringer’s, and a multielectrolytes solution. Explants were incubated in each solution (1 hour, 37 °C), then analyzed for chondrocyte viability and gene expression, while the conditioned supernatant was assessed for glycosaminoglycan release. Additional explants were flushed with one of the solutions using a syringe and 18-gauge needle to simulate pulse lavage, followed by chondrocyte viability analysis.</div></div><div><h3>Results</h3><div>No significant differences in chondrocyte viability were observed across the 3 solutions (<em>P</em> <!-->&gt;<!--> <!-->.90). Compared to saline, gene expression analysis showed lactated Ringer’s reduced MMP13, COL2A1, and IL6, though not significantly, while the multielectrolytes significantly reduced all 3 (<em>P</em> <!-->&lt;<!--> <!-->.001). No significant differences were found between lactated Ringer’s and multielectrolytes. Glycosaminoglycan release was similar across the 3 solutions.</div></div><div><h3>Conclusions</h3><div>Neither lactated Ringer’s nor multielectrolytes solution caused increased chondrocyte death or cartilage damage compared to saline in this in vitro model, both for incubation and bone marrow flushing. These solutions may be viable alternatives for preserving cartilage integrity in orthopedic procedures.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"5 4","pages":"Article 100247"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145698163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying the effect of hinge axis orientation on the posterior tibial slope angle during medial opening wedge high tibial osteotomy","authors":"Timothy A. Burkhart ,&nbsp;Victor A. Carranza ,&nbsp;Thiago Vivacqua ,&nbsp;Alan Getgood ,&nbsp;Ryan Willing","doi":"10.1016/j.jcjp.2025.100254","DOIUrl":"10.1016/j.jcjp.2025.100254","url":null,"abstract":"<div><h3>Introduction</h3><div>Research has suggested that rotating a medial open wedge high tibial osteotomy hinge axis internally or externally can change the posterior tibial slope and may create abnormal loading patterns through the tibia.</div></div><div><h3>Objectives</h3><div>(1) To develop and validate a finite element model that estimates posterior tibial slope following a medial opening wedge high tibial osteotomy with a prescribed hinge axis; (2) use the model to evaluate the effect hinge axis rotation has on the posterior tibial slope and medial mechanical proximal tibia angle; and (3) quantify the effect of rotating the hinge axis on the stress and strain response within the anterior and posterior regions of the hinge.</div></div><div><h3>Methods</h3><div>Five tibia finite element models were reconstructed from computed tomography scans of 5 cadaveric specimens. Three different hinge axis rotations were tested (15° external rotation, neutral, and 15° internal rotation) in each of the 5 models and the resulting posterior tibial slope, stresses, and strains were analyzed.</div></div><div><h3>Results</h3><div>A 15° externally rotated hinge significantly increased the posterior tibial slope angle compared with the preoperative alignment. The 15° externally rotated hinge experienced greater stresses and strains in the posterior region of the hinge, while the 15° internally rotated hinge experienced higher stresses and strains in the anterior region of the hinge.</div></div><div><h3>Conclusions</h3><div>The orientation of the medial open wedge high tibial osteotomy hinge can be manipulated to alter the posterior tibial slope but that changes in the stresses can also occur and this should be considered in the presurgical planning phase to reduce the risk of complications (eg, lateral cortical fractures).</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"5 4","pages":"Article 100254"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145698161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return to sports and physical activity after implantable shock absorber surgery for patients with medial knee osteoarthritis","authors":"Seth L. Sherman ,&nbsp;Anil S. Ranawat ,&nbsp;Marcin Domzalski ,&nbsp;Dennis C. Crawford","doi":"10.1016/j.jcjp.2025.100245","DOIUrl":"10.1016/j.jcjp.2025.100245","url":null,"abstract":"<div><h3>Objectives</h3><div>Symptomatic knee osteoarthritis (OA) is a leading cause of disability. High tibial osteotomy and knee arthroplasty can deliver excellent outcomes, but are complicated by morbidity, times, and activity limitation. This study assesses activities of patients treated with an implantable shock absorber (ISA) that permits immediate weight bearing and unrestricted postoperative range of motion.</div></div><div><h3>Methods</h3><div>Subjects were prospectively treated with an ISA, 99% of whom had postprocedural physical therapy. Subjects rated their desired activities at baseline through 24<!--> <!-->months. Subjects also rated their sports and recreation function and degree to which their knee feels “normal.”</div></div><div><h3>Results</h3><div>Data were available from 73 of 81 (91%) subjects. At baseline, 1.8% of activities could be performed with minimal or no limitation, while at 24<!--> <!-->months, 64.4% could be performed with minimal or no limitation (<em>P</em> <!-->&lt;<!--> <!-->.0001). Improvement was consistent across high impact, strength, and flexibility activities. Sports and recreation function on the Knee Injury and Osteoarthritis Outcome Score scale improved from a mean of 13.8 at baseline to 62.3 at 24<!--> <!-->months (<em>P</em> <!-->&lt;<!--> <!-->.0001). Furthermore, 69% of subjects stated that their knee “never” felt normal at baseline, which decreased to 19% at 24<!--> <!-->months (<em>P</em> <!-->&lt;<!--> <!-->.0001).</div></div><div><h3>Conclusions</h3><div>Treatment with ISA removed many activity limitations and made knees feel more normal, likley due to immediate return to full weight-bearing and no activity restriction. ISA represents a proven therapeutic option that provides symptomatic relief as well as return of activity.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"5 4","pages":"Article 100245"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145698159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preparation of alpha-2 macroglobulin–rich plasma from human blood—technique and compositional analysis of plasma, platelet-rich plasma, platelet-poor plasma, and alpha-2 macroglobulin–rich plasma","authors":"Kelly K. Showel ,&nbsp;Christopher H. Evans ,&nbsp;Rodolfo E. De la Vega ,&nbsp;Gresin P. Hawse ,&nbsp;Karina Gonzalez Carta ,&nbsp;Daniël B.F. Saris ,&nbsp;Jacob L. Sellon ,&nbsp;Brennan J. Boettcher","doi":"10.1016/j.jcjp.2025.100255","DOIUrl":"10.1016/j.jcjp.2025.100255","url":null,"abstract":"<div><h3>Introduction</h3><div>Alpha-2 macroglobulin (A2M) has been identified as an inhibitor of matrix metalloproteinases, interleukin-1β and other factors that contribute to post-traumatic osteoarthritis. The therapeutic use of intra-articular A2M requires a standardized protocol for its preparation, coupled with compositional analysis of the product.</div></div><div><h3>Objectives</h3><div>(1) To develop and describe a protocol for producing A2M-rich plasma (A2MRP) from platelet-poor plasma (PPP), which is a byproduct of platelet-rich plasma (PRP) production. (2) To provide a comprehensive analysis of A2M and cytokine levels in plasma, PRP, PPP, and A2MRP.</div></div><div><h3>Methods</h3><div>Ten patients undergoing standard preparation of PRP with the Arthrex Angel system consented to have their PRP and by-products analyzed. Sixty mL of PPP were filtered through a Hemocor Junior High Performance Hemoconcentrator, resulting in the production of 12 mL of A2MRP. The concentrations of A2MRP and certain cytokines were determined by enzyme-linked immunosorbent assay and multiplexing. A2M bioactivity was confirmed by trypsin inhibition.</div></div><div><h3>Results</h3><div>Mean A2M concentrations in plasma, PRP, PPP, and A2MRP were 1.56, 1.62, 1.62, and 6.66 mg/mL, respectively. insulin-like growth factor 1 concentrations were measured as 68.82, 51.35, 69.23, and 257.63 ng/mL in plasma, PRP, PPP, and A2MRP, respectively. Multiplex analysis showed alterations in the concentrations of several cytokines and growth factors in PRP compared to A2MRP, plasma, and PPP. The A2M within A2MRP was biologically active.</div></div><div><h3>Conclusions</h3><div>Our results demonstrated that ultrafiltration of PPP is a reliable, quantitative method for concentrating active A2M. The levels of certain cytokines and growth factors were also affected. These data pave the way for clinical trials of intra-articular A2MRP in osteoarthritis.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"5 4","pages":"Article 100255"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145698164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided meniscal injection of autologous conditioned plasma: a case series at middle-term evaluation","authors":"Margherita Vacca ,&nbsp;Luca Ruosi ,&nbsp;Giulia Marcella Maryse Chiari Gaggia ,&nbsp;Beatrice Balzarini ,&nbsp;Giuseppe Anzillotti ,&nbsp;Pietro Conte ,&nbsp;Berardo Di Matteo ,&nbsp;Elizaveta Kon ,&nbsp;Daniele Altomare","doi":"10.1016/j.jcjp.2025.100242","DOIUrl":"10.1016/j.jcjp.2025.100242","url":null,"abstract":"<div><h3>Introduction</h3><div>Symptomatic degenerative meniscal tears are a tough challenge in daily clinical practice for orthopedic surgeons. Arthroscopic partial meniscectomy led to high cost, little improvement to Quality of Life and faster progression of OA. Thus, urgency for new conservative therapeutic strategies is emerging.</div></div><div><h3>Objectives</h3><div>To provide a report of the results of ultrasound (US)-guided intrameniscal injections with a solution of autologous conditioned plasma (ACP) in a group of active patients suffering of symptomatic degenerative meniscal tears.</div></div><div><h3>Methods</h3><div>Forty-seven patients were treated by 3 US-guided intra- and perimeniscal injections of ACP (Arthrex) at 2<!--> <!-->weeks interval, and prospectively assessed at baseline and at 12, 24 and then at final 36<!--> <!-->months’ follow-up, using Knee Injury and Osteoarthritis Outcome Score, International Knee Documentation Committee-subjective score, Visual Analog Scale, Tegner Activity Scale.</div></div><div><h3>Results</h3><div>Around two-thirds of the patients (32, 68.09%) declared to be satisfied by the procedure.</div><div>No correlation was found between age, sex, and body mass index and score variation, according to the multivariate analysis.</div><div>Thirty patients (63.8%) registered an increase of at least 10 points in Knee Injury and Osteoarthritis Outcome Score at 1<!--> <!-->year of follow-up, thus were identified as responder. Seventeen failures were reported (failure rate: 36%).</div></div><div><h3>Conclusions</h3><div>This study highlighted the potential benefit of an US-guided intrameniscal injective procedure using ACP for the management of symptomatic degenerative meniscal lesions. Further randomized controlled studies are needed to confirm the efficacy of ACP as a therapeutic option for degenerative meniscal tears.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"5 3","pages":"Article 100242"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateral meniscal allograft transplantation with concomitant osteochondral allograft of the lateral femoral condyle and trochlea: a mid-term outcome case report","authors":"Molly Canfield,&nbsp;Katie McMorrow,&nbsp;Andrew S. Bi,&nbsp;Joshua Wright-Chisem,&nbsp;Brian J. Cole","doi":"10.1016/j.jcjp.2024.100230","DOIUrl":"10.1016/j.jcjp.2024.100230","url":null,"abstract":"<div><h3>Introduction</h3><div>Meniscal deficiency and osteochondral defects of the knee are difficult pathologies to treat in isolation for knee preservationists. In conjunction, surgical treatment options may appear limited or daunting; however recent literature has demonstrated the feasibility of performing both meniscal allograft transplantation and osteochondral allograft in the same surgical setting.</div></div><div><h3>Case presentation</h3><div>In this case report, we present a 31-year-old male who underwent lateral meniscal allograft transplantation with concomitant osteochondral allograft of both the lateral trochlea and lateral femoral condyle, including surgical technique, postoperative rehabilitation, and 8-year clinical follow-up with patient-reported outcomes.</div></div><div><h3>Conclusion</h3><div>Concomitant lateral meniscal allograft transplantation and double osteochondral allograft procedures demonstrate promising clinical outcomes and graft incorporation, as evidenced by an 8-year follow-up showing excellent graft survival and favorable patient-reported outcomes. This case highlights the potential of combined surgical approaches as a feasible option for addressing meniscal deficiency and multiple osteochondral defects of the knee.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"5 3","pages":"Article 100230"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of bone marrow aspirate concentrate with thrombin used for repairing osteochondral lesions of the talus","authors":"Tian Lan ,&nbsp;Karina T. Wright ,&nbsp;Nilesh Makwana ,&nbsp;Andrew Bing ,&nbsp;Charlotte H. Hulme ,&nbsp;Helen S. McCarthy","doi":"10.1016/j.jcjp.2025.100237","DOIUrl":"10.1016/j.jcjp.2025.100237","url":null,"abstract":"<div><h3>Introduction</h3><div>Bone marrow aspirate concentrate (BMAC) is an autologous biological augment used in the treatment of osteochondral lesions of the talus. Several studies have reported the short-term efficacy of BMAC for repair of osteochondral lesions of the talus, however, there is minimal regulation of the autologous products' potency and “release criteria” for clinical use. Moreover, the mechanism of action of BMAC therapy is poorly understood.</div></div><div><h3>Objectives</h3><div>This study aimed to investigate the composition of BMAC and BMAC mixed with thrombin (B+T), prepared according to commercial Complete Cartilage Regeneration kit protocols, linked to functional outcome data.</div></div><div><h3>Methods</h3><div>Bone marrow aspirate, BMAC, and B+T samples (<em>n</em> <!-->=<!--> <!-->16) were obtained for cellular analysis via a hematology analyzer and colony-forming unit-fibroblast assay. Molecular composition was assessed via a multiplex 27-cytokine assay and enzyme-linked immunosorbent assay (<em>n</em> <!-->=<!--> <!-->12). Spearman rank correlation was used to assess the relationship between both cellular and molecular composition with patient functional outcomes.</div></div><div><h3>Results</h3><div>Mesenchymal stem cells and platelets were concentrated in BMAC compared with bone marrow aspirate, but were reduced significantly after addition of thrombin. Cytokines and growth factors also decreased in concentration in B+T, however, platelet-derived growth factor-BB and interleukin-1 receptor alpha were significantly increased. Basic fibroblast growth factor, Eotaxin, IL-4, and IL-17 were found to have a positive correlation with worsening Manchester-Oxford Foot and Ankle Questionnaire (MOXFQ) 7<!--> <!-->months postoperation.</div></div><div><h3>Conclusions</h3><div>This study provides insight into the cellular and molecular characteristics of BMAC and B+T, highlighting donor heterogeneity and the importance of profiling autologous products prior to treatment.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"5 3","pages":"Article 100237"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of comorbid anxiety and major depression on functional outcomes in meniscectomy","authors":"Yusuf N. Mufti ,&nbsp;Jared P. Sachs ,&nbsp;David Christian ,&nbsp;Kevin Wang ,&nbsp;Allen Yazdi ,&nbsp;Fatima Bouftas ,&nbsp;Robert Gibbons ,&nbsp;Corey Goldstein ,&nbsp;Brian J. Cole","doi":"10.1016/j.jcjp.2025.100241","DOIUrl":"10.1016/j.jcjp.2025.100241","url":null,"abstract":"<div><h3>Introduction</h3><div>Psychiatric disorders such as depression and anxiety are prevalent but often unrecognized in orthopedic settings. While psychiatric conditions are known to affect functional outcomes in a variety of orthopedic procedures, limited data exist on their impact after meniscectomy.</div></div><div><h3>Objectives</h3><div>To evaluate the influence of comorbid anxiety and depression on pain and functional outcomes following meniscectomy.</div></div><div><h3>Methods</h3><div>Between August 2016 and January 2018, 141 patients scheduled for arthroscopic meniscectomy were prospectively recruited. Preoperatively, they completed the Computerized Adaptive Testing-Mental Health (CAT-MH) questionnaire, screening for major depressive disorder (MDD), anxiety, and mania. Functional outcome measures (IKDC, KOOS, SF12, VR12, and VR6D) were collected preoperatively and 6<!--> <!-->months postoperatively. Outcomes were compared between patients with and without MDD, and symptoms of anxiety and mania were correlated with outcome scores.</div></div><div><h3>Results</h3><div>Of the 141 patients, 120 completed the study. Thirteen patients (10.9%) screened positive for MDD, 10 (76.9%) of whom were female. Women reported lower levels of function on almost all measures. MDD-positive patients reported lower outcomes preoperatively and postoperatively. Higher anxiety levels were linked with lower baseline and postoperative scores. Both MDD-positive and -negative cohorts showed significant improvements in most outcome measures postoperatively. There was no difference in the extent of improvement between groups. Mania had no impact on outcomes.</div></div><div><h3>Conclusions</h3><div>Comorbid anxiety and depression were associated with worse preoperative and postoperative functional outcomes after meniscectomy, though both groups show similar improvement. These findings highlight the need for better mental health screening tools in orthopedics, as psychiatric conditions may disproportionately influence patient-reported outcomes.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"5 3","pages":"Article 100241"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Welcome to the third issue of JCJP 2025","authors":"Rachel M. Frank ,&nbsp;Lucienne A. Vonk ,&nbsp;Elizaveta Kon","doi":"10.1016/j.jcjp.2025.100259","DOIUrl":"10.1016/j.jcjp.2025.100259","url":null,"abstract":"","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"5 3","pages":"Article 100259"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combination of osteochondral allograft transplantation and particulated juvenile articular cartilage to treat osteochondral defects leads to low failure rates after a minimum of 2-year follow-up","authors":"Gergo Merkely ,&nbsp;Chilan B.G. Leite ,&nbsp;Christos Papavassiliou ,&nbsp;Alec Reihl ,&nbsp;Jakob Ackermann ,&nbsp;Christian Lattermann ,&nbsp;Andreas H. Gomoll","doi":"10.1016/j.jcjp.2025.100236","DOIUrl":"10.1016/j.jcjp.2025.100236","url":null,"abstract":"<div><h3>Introduction</h3><div>Osteochondral allograft (OCA) transplantation effectively treats osteochondral defects using circular dowels. However, covering large or irregular defects with single plugs or two plug techniques sacrifices normal cartilage.</div></div><div><h3>Objectives</h3><div>To assesses failure rates of combining OCA transplantation with particulated juvenile allograft cartilage (PJAC) for treating large, irregular osteochondral lesions.</div></div><div><h3>Results</h3><div>Thirty-five patients were included. Mean age was 33.7 ± 8.8 years old (range, 15-49); follow-up 3.9 ± 1.4 years (range, 2.1-6.7); BMI 27.8 ± 5.0 kg/m²; defect size 4.9 ± 3 cm², and the mean OCA diameter was 1.9 ± 0.7 cm. PJAC was inserted around the OCA in 28 patients (80.0%), and between 2 grafts in 7 (20%) patients. Four cases of failure occurred (11.4%), with a mean time-to-failure of 3.7 ± 1.9 years (range, 2.1-6.4). Among failed cases, PJAC placement was around the OCA in 3 cases, and between 2 grafts in 1 case and defect size was larger compared to cases when graft remained intact.</div></div><div><h3>Conclusions</h3><div>Combining different methods of treatment for osteochondral defects may increase advantages and overcome drawbacks of each technique. The combination of OCA and PJAC appears to be a viable strategy for the management of large, irregular osteochondral lesions.</div></div>","PeriodicalId":100760,"journal":{"name":"Journal of Cartilage & Joint Preservation","volume":"5 3","pages":"Article 100236"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}