Editorial Commentary: Osteochondral Allograft Transplantation of the Knee Using Nonorthotopic Grafts: A "Mismatch" Made in Heaven.

Abstract

Osteochondral allograft (OCA) transplantation is a safe and reliable cartilage restoration procedure that has significantly increased in use over the last decade. As clinical studies report improved patient outcomes, sustained return to high-demand physical activity, and excellent long-term graft survivorship, OCA transplantation has become a popular first-line treatment option for symptomatic cartilage defects of the femoral condyle. Unfortunately, the rise in demand has not been met by a concomitant increase in supply, and OCAs remain a limited resource that must be used in a short window of time, or risk being wasted. As such, several studies are now exploring the use of nonorthotopic (e.g., lateral donor for medial defect) OCA grafts to expand graft use and provide more convenient surgical treatment. Imaging studies have proven the capability of nonorthotopic OCA grafts to restore the articular surface within acceptable limits, and midterm clinical studies have had successful patient outcomes, thereby suggesting significant promise for this surgical strategy.