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Current Techniques for Processing Osteochondral Allografts Are Variable: A Systematic Review.

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Arthroscopy, Sports Medicine, and Rehabilitation
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Optimal storage for osteochondral allografts (OCAs) is unclear. While 4°C is common, 37°C and room temperature storage show promise for chondrocyte viability, but storage media lack consensus.

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Tissue Engineering

Background:

  • Osteochondral allografts (OCAs) are crucial for knee resurfacing.
  • Current processing and storage methods for OCAs lack standardized optimal protocols.
  • Understanding best practices is vital for successful clinical application.

Purpose of the Study:

  • To systematically review and synthesize current evidence on optimal processing and storage protocols for fresh cold-stored osteochondral allografts (OCAs).
  • To evaluate in vivo and ex vivo studies investigating OCA preservation techniques.
  • To identify gaps in knowledge regarding OCA storage and processing.

Main Methods:

  • Systematic review adhering to PRISMA guidelines.
  • Searched PubMed, Embase, and Scopus databases for relevant peer-reviewed articles.
  • Included in vivo and ex vivo human studies, excluding reviews and nonhuman research. Data extracted included storage conditions, media, and outcomes.

Main Results:

  • 27 studies met inclusion criteria, including 8 in vivo and 19 ex vivo human studies.
  • 4°C was the most common storage temperature (78.95%), with some studies exploring 37°C and room temperature.
  • 19 different storage media were investigated, with 68.42% using additives; consensus on media remains elusive.

Conclusions:

  • 4°C storage is prevalent but may not be optimal for chondrocyte viability.
  • Alternative temperatures (37°C, room temperature) and specific preservation systems show potential for improved chondrocyte density.
  • Further research is needed to establish consensus on storage media and protocols for OCAs.