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Osteochondral allografts for osteochondritis dissecans and osteonecrosis of the femoral condyles

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Summary

Osteochondral allografts were used in 11 patients with osteochondritis dissecans and 4 with osteonecrosis of the femoral condyles. The lesions were mainly in the medial condyle in 13 cases, and in the weightbearing area in 10. The grafts had a mean size of 6 cm2; 8 were kept in hypothermia at 4° C for less than 24 h and 7 were stored at −80° C with cryoprotection. After an average follow up of 3.2 years, only 2 patients needed a further operation, one for nonunion and the other for a fracture of the graft. The others had improved clinically and showed radiological union of the graft with preservation of the joint space.

Résumé

Nous avons traité quinze patients qui présentaient une lésion sévère mais limitée des condyles fémoraux, en utilisant des allogreffes ostéochondrales pour combler la perte de substance. Il s'agissait de onze ostéochondrites disséquantes et de quatre ostéonécroses. Huit de ces greffes avaient été conservées en hypothermie à 4° C pendant moins de 24 heures, tandis que les autres avaient été congelées avec cryoprotection. La plupart des lésions siégeaient au niveau du condyle interne (13 cas) et dans la zone de charge (10 cas). La taille moyenne des greffes était de 6 cm2. Après un recul moyen de 3.2 ans, seulement deux patients ont dû être réopérés, l'un pour défaut d'incorporation du greffon, l'autre pour fracture de la greffe. Tous les autres malades sont cliniquement améliorés par rapport à l'état pré-opératoire, avec incorporation radiologique de la greffe et conservation de l'interligne articulaire.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University Hospital San Carlos, Madrid, Spain

    F. Marco, F. Lopez-Oliva, J. M. Fdez Fedz-Arroyo, J. A. de Pedro, A. J. Perez, C. Leon & L. Lopez-Duran

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  1. F. Marco
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  2. F. Lopez-Oliva
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  3. J. M. Fdez Fedz-Arroyo
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  4. J. A. de Pedro
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  5. A. J. Perez
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  6. C. Leon
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  7. L. Lopez-Duran
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Marco, F., Lopez-Oliva, F., Fedz-Arroyo, J.M.F. et al. Osteochondral allografts for osteochondritis dissecans and osteonecrosis of the femoral condyles. International Orthopaedics 17, 104–108 (1993). https://doi.org/10.1007/BF00183551

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