Damaged or diseased articular cartilage has limited intrinsic repair capabilities, and the natural history of affected joints is generally poor, leading to progressive arthrosis. The use of fresh human osteochondral allografts to replace articular cartilage defects and resurface areas of osteoarthrosis, and in the reconstruction of acquired osteochondral defects caused by trauma and disease, is an area of growing interest in the arthritis and orthopaedic community. A major obstacle to more wide-spread utilization of allografting is the inherent difficulties in procurement, processing, testing, and delivery of grafts; thus, the number of patients waiting for or eligible to undergo this procedure exceeds the amount of available tissue. This is primarily because the window of permissible storage time for this fresh tissue is narrow; and therefore, presently, these procedures can only be done in specialized centers. In the present study, we propose to assess chondrocyte viability, chondrocyte metabolic activity, cartilage matrix composition, and biomechanical properties within osteochondral plugs stored in different solutions. These solutions will be lactated Ringer's (to serve as a control), allograft storage media, allograft storage media plus fetal bovine serum, and allograft storage media containing defined media supplement insulin, transferrin and selenium (ITS); or vitamin C plus insulin-like growth factor-1. We also propose to investigate the effect of temperature on storage of osteochondral allografts, and the effect of the storage of osteochondral allografts with varying amounts of bone. We hypothesize that the more bone stored with articular cartilage, the greater the adverse effect on cartilage. This study should provide a framework in understanding the optimization of storage conditions for the preservation of osteochondral allografts, as well as a more complete understanding of the scientific basis for osteochondral allograft storage. The data should allow enhanced tissue banking and improve the availability of the limited supply of osteochondral allografts to fulfill the clinical need of these grafts in the treatment of individuals with articular cartilage injury and disease.
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