|MadSci Network: Medicine|
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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