Fresh osteochondral grafting in the United States: the current status of tissue banking processing
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FULL LENGTH REVIEW
Fresh osteochondral grafting in the United States: the current status of tissue banking processing Brett Goodfriend . Anthony A. Essilfie . Ian A. Jones . C. Thomas Vangsness Jr.
Received: 17 September 2018 / Accepted: 16 April 2019 Ó Springer Nature B.V. 2019
Abstract The use of musculoskeletal allografts has become increasingly popular among surgeons. The purpose of this review is to highlight the procurment and delievery process of fresh osteochondral allografts in the United States. The four distributors of fresh osteochondral allografts in the United States were contacted. Surveys containing quantitative and qualitative sections concerning the procurement and processing of osteochondral allograft tissue were obtained. Our results showed an average of 13 ± 4.24 years of experience with osteochondral allografts. The average donor age ranged from 13.5 ± 3 to 37.5 ± 5 years, with an average age of 27 ± 2.83 years. All donors were between ages 12 and 45 years old. The percentage of screened donors that were accepted for allograft transplant was consistent at 70–75% for 3 out of the 4 tissue banks.
B. Goodfriend A. A. Essilfie C. Thomas Vangsness Jr. Department of Orthopedic Surgery, USC Keck School of Medicine, 1540 Alcazar Street, CHP 207, Los Angeles, CA 90089-9007, USA C. Thomas Vangsness Jr. (&) Department of Orthopaedic Surgery, USC Keck School of Medicine, 1520 San Pablo Street, Suite 2000, Los Angeles, CA 90089-9007, USA e-mail: [email protected] I. A. Jones School of Medicine, University of California, Irvine, 1001 Health Sciences Rd, Irvine, CA 92617, USA
The percentage of grafts that expire without implantation ranged from 20% to 29%. Maximum shipping time varied between 24 and 96 hours. Each tissue bank used its own proprietary storage medium. The time from donor death to the harvest of allograft tissue was \ 24 hours. The most commonly requested osteochondral allograft tissue for all banks was the medial femoral condyle. The market share of fresh allografts is as follows: Joint Restoration Foundation (JRF) 59.9%, Muskuloskeletal Transplant Foundation (MTF) 15.3%, LifeNet Health (LN) 14.5%, and Regeneration Technology Incorporated (RTI) 10.2%, with approximately 4700 fresh allografts distributed in 2018. This compiled data from the four tissue banks that supply fresh osteochondral allograft in the United States provides important background information for patients and orthopaedic surgeons. Keywords Osteochondral Allograft Transplant Tissue Banking
Background A number of surgical options are available for patients with grade IV localized cartilage defects. These options include microfracture, osteochondral autograft, osteochondral allograft (OCA), autologous cartilage implantation (ACI), and the recently
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Cell Tissue Bank
approved matrix-associated chondrocyte implantation (MACI). All of these surgical interventions are performed with the hope of alleviating pain and improving daily function in young, active patien
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