MadSci Network: Medicine
Query:

Re: alter text

Date: Thu Oct 1 05:22:25 1998
Posted By: cornell clark, M.D., B.S. Chemistry, 1977, Carnegie Mellon University, none
Area of science: Medicine
ID: 906517801.Me
Message:

Transplantation of  bone is autograft or allograft; in autograft 
transplantation the donor is the recipient; in allograft transplantation 
the donor and recipient are genetically dissimilar.

Transplantation of a cadaveric knee joint would consider the following: 
technical or surgical practicality; acceptance or rejection of the 
transplanted tissue; outcome of procedure in comparison to the total knee 
replacement with a metal or plastic prosthesis; and the mechanism of bone 
repair. 

Knee replacement surgery is most commonly done for advanced arthritis: the 
inflammatory process has worn away the cartilage with some involvement of  
bone.

The mechanism of  bone growth and regeneration used in healing a fractured 
bone is used for incorporation of  transplanted bone tissue (limited by 
transplanted bone processed by freeze-drying or deep freezing to make it 
less immunogenic or likely to cause rejection, thereby reducing it’s 
biologic activity: osteogenesis - ability of bone to regenerate itself
by production of new bone by osteoblasts; osteoclastic resorption - ability 
to remove bone mineral mediated by osteoclasts; osteoinduction - ability to 
stimulate new bone formation by recruitmant of cells able to change into 
bone remodeling cells; and osteoconduction - bone grafts ability to 
function as a scaffold for ingrowth of blood vessels and cells capable
of providing for new bone formation. Autograft bone posseses all of the 
former  properties described earlier. Allograft bone only posseses the 
property of osteoconduction (1).

Autologous chondrocyte transplantation is being investigated for repair of 
arthritic knee joints with limited mobility. It has the advantage of being 
an autograft, and technically more feasible since involved knee joint is 
not removed - only remodeled with the aid of chondrocytes. 

I am continuing a literature search for cases of  transplanted cadaveric 
knee joints.

References:

1. Garbuz, David. “Biology of Allografting.” Orthopaedic Clinics of North 
America. 29.2(1998):199-204. 

2. Brittberg, Matt. “Treatment of Deep Cartilage Defects in the Knee with 
Autologous Chondrocyte Transplantation.” New England Journal of Medicine. 
331.14 (1994):889-95.


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