A 59-year-old Massachusetts female was
presented with concern for right knee rejection of a
bone/cartilage transplant, recurring dislocation, and
instability of the knee for several years.
Patient had been plagued with a knee problem since a
skiing accident 10 years ago. A year after initial
injury, a metal plate was attached to strengthen the
knee joint, followed by an Osteochondral Allograft
surgical procedure which transplants a cartilage section
and attached bone from a cadaver donor to the damaged
region of the joint surface. She required crutches to
aid walking for nearly one year and subsequently
developed Osteoporosis in the knee’s right lower
extremity while her body began rejection of the
transplant. Despite the unsuccessful procedures (to
avoid knee replacement), a second Osteochondral
Allograft was undertaken, followed by more
non-weight-bearing ambulation which continued and
heightened the osteoporosis condition.
Patient upon entering The Center for Regenerative
Medicine sought assistance to prevent possible rejection
and potential future knee replacement. Otherwise
healthy, patient uses Fosomax for Osteoporosis relief
and
anti-inflammatory medications. Well-educated
(Ph.D in Physical Therapy), her family history is
non-contributory.
Discussion:
Department of Orthopedic Surgery and Rehabilitation,
University of California, San Diego: The following
are the results of a study of 58 patients with recent
Osteochondral allograft knee transplants:
Most patients in this study mostly had severe,
Osteochondritis Dissecans, a traumatic defect
or osteonecrosis of the femoral condyle, a
painful, healed depressed fracture or traumatic defect
of the tibial plateau, and unicompartmental
traumatic
Osteoarthritis of the knee. All patients
reported disabling pain after failure of attempts to
correct problems surgically. Of 39
patients available for follow-up study after allograft
transplants, nine (22.5 per cent) failed and of those
patients with unicompartmental traumatic
arthritis, the rate of success was only 30 per cent.
