Allografts (bony, cartilaginous graft) from donor

In many cases chondral defect are extended in size and the repair of the cartilage only would not bring acceptable results. In these stances the repair using graft form donor is a reasonable option. Grafts are removed from cadavers under sterile circumstances and kept cool in special storage medium until the surgery.

Organ transplants are widely known by the public and by now is a well established option in surgery. Bone grafting from cadavers has been used for decades and it offers great success in revision arthroplasty or spinal fusion surgeries. In the recent years mosaicplasty is performed occasionally not only with using autografts, but grafts from donors (allografts) as well. In these cases no donor site morbidity is expected. Furthermore, in cases of large osteochondral defect large sized osteochondral grafts may be implanted, that could be the size of the half of the joint, like in condyle implants. These procedures are suitable for younger patients, where arthroplasty is to be postponed. As grafts are fairly large, the inner centre of the grafts may necrotize and impression of the articular surface may occur.

Major concern is the transmission of viral diseases and the rejection of the implanted tissue. Cartilage is a very immunoprivileged tissue and bone has only moderate immunogenity, thus rejection of the implants is infrequent. Viral transmission of diseases like hepatitis or HIV is the biggest concern of the patients, even though using the novel screening methods for viruses the realistic odds are very low (1:1.000.000 or even lower).