Osteochondral Transplantation Techniques for Articular Cartilage Repair

Osteochondral transplantation encompasses surgical approaches designed to restore both the cartilage surface and the underlying subchondral bone in joints compromised by focal defects. Techniques range from marrow stimulation procedures—such as microfracture, which recruits mesenchymal stem cells from the bone marrow—to cell‐based strategies, including autologous chondrocyte implantation (ACI) and matrix‐induced ACI (MACI). Osteochondral autograft transplantation (OAT or mosaicplasty) harvests small plugs of healthy cartilage and bone from non‐weight‐bearing regions and implants them into chondral lesions, achieving immediate structural congruity but limited by donor‐site availability. Osteochondral allograft transplantation (OCA) uses cadaveric grafts to address larger defects whilst bypassing donor morbidity, though preservation and immunogenicity of graft tissue remain critical factors. Recent advances include the development of cryopreserved viable osteochondral allografts to augment marrow stimulation and biphasic scaffolds seeded with chondrocytes for combinatorial repair. Success hinges on graft integration, restoration of the osteochondral unit’s mechanical properties and zonal architecture, and optimised rehabilitation protocols to promote hyaline‐like tissue formation and long‐term joint function.

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Osteochondral Transplantation Techniques for Articular Cartilage Repair publication trend

The graph below shows the total number of articles in osteochondral transplantation techniques for articular cartilage repair across all publications each year (not limited to Nature Index journals).

Technical terms

Osteochondral transplantation: Surgical restoration of both articular cartilage and subchondral bone to repair focal joint defects.

Autograft (OAT/mosaicplasty): Harvesting patient’s own cartilage‐bone plugs from low‐load regions to implant into defects.

Allograft (OCA): Use of donor cartilage-bone tissue to treat larger or multiple defects without harvesting from the patient.

Microfracture: Drilling small holes into subchondral bone to stimulate marrow-derived stem cells and fibrocartilaginous repair.

Autologous chondrocyte implantation (ACI): Two‐stage procedure involving harvesting chondrocytes, expanding them in vitro and reimplanting under a periosteal or synthetic cover.

References

1. Autologous chondrocyte implantation, matrix‐induced autologous chondrocyte implantation, osteochondral autograft transplantation and osteochondral allograft improve knee function and pain with considerations for patient and cartilage defects characteristics: A systematic review and meta‐analysis. Knee Surgery, Sports Traumatology, Arthroscopy (2024).
2. Knee Joint Preservation in Tactical Athletes: A Comprehensive Approach Based upon Lesion Location and Restoration of the Osteochondral Unit. Bioengineering (2024).
3. Microfracture technique versus osteochondral autologous transplantation mosaicplasty in patients with articular chondral lesions of the knee: a prospective randomized trial with long‐term follow‐up. Knee Surgery, Sports Traumatology, Arthroscopy (2014).
4. A novel, cryopreserved, viable osteochondral allograft designed to augment marrow stimulation for articular cartilage repair. Journal of Orthopaedic Surgery and Research (2015).
5. Evaluation of Magnetic Nanoparticle-Labeled Chondrocytes Cultivated on a Type II Collagen–Chitosan/Poly(Lactic-co-Glycolic) Acid Biphasic Scaffold. International Journal of Molecular Sciences (2017).