Bone and cartilage allotransplantation. A review of 14 years of research and clinical studies.

The authors review their experience of over 14 years in the field of osteochondral allotransplantation. Experimental studies demonstrated the immunogenicity of bone and cartilage, immunosuppression in skeletal transplantation models, and a subset of myeloid cells within bone marrow with strong immunogenic properties. Clinical results of knee joint resurfacing with fresh small-fragment osteochondral allografts have been best in posttraumatic joints. Experience with allograft reconstructions of skeletal defects after tumor surgery has been gratifying as a limb salvage procedure. Microvascular fibular autografts have been an important adjunct in massive reconstructive osteochondral transplantation.