A clinical and histologic analysis of failed fresh osteochondral allografts.

Fresh small osteochondral allografts were implanted in 108 patients. A clinical and histologic analysis was undertaken in 18 patients whose grafts failed and were excised. Twelve of these patients had evidence of viable hyaline cartilage despite adverse conditions. If careful attention is given to patient selection, age, appropriate timing for correction of alignment, and meticulous technique associated with graft positioning, size, and thickness, then the incidence of clinical failure should be minimized.