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Online ISSN 1827-1707
Giannini S., Vannini F.
Istituti Ortopedici Rizzoli, Bologna
The development of post-traumatic arthritis is a frequent eventuality leading to severe functional limitation and psychological impairment, mostly in young and active patients. Although the damage can be severe, total joint replacement seems to be a difficult choice due to the young age and functional demand of these particular patients. The rationale behind fresh osteochondral allografting is essentially the transplantation of an intact organ as hyaline articular cartilage, into a diseased or damaged area of the joint resulting in an improved function without compromising the possibility of future total prosthetic replacement. Different procedures as chondral debridement, drilling, microfracture, periosteal transplant, autologous chondrocytes transplant, and autologous osteochondral transplant have been proposed; however, none of these methods, although effective in their own indications, have proven capable to restore extensive damage to the arti- cular surface, especially in cases of kissing lesions. The purpose of this paper is to review the state of the art of the allograft transplantation technique and to highlight some points deserving further research, such as osteochondral bipolar resurfacing of the ankle. Although it is a high demanding procedure, it appears to be a reliable alternative to arthrodesis in the treatment of post-traumatic ankle arthritis of the young and active patient.