A Bedside-to-Bench-to-Bedside Journey to Advance Osteochondral Allograft Transplantation towards Biologic Joint Restoration

James L. Cook; James P. Stannard; Aaron M. Stoker; Kylee Rucinski; Brett D. Crist; Cristi R. Cook; Cory Crecelius; Chantelle C. Bozynski; Keiichi Kuroki; Lisa A. Royse; Renee Stucky; Clark T. Hung; Matthew J. Smith; Kyle M. Schweser; Clayton W. Nuelle; Steven DeFroda

doi:10.1055/a-2506-2675

The Journal of Knee Surgery, Table of Contents

J Knee Surg 2025; 38(05): 256-271
DOI: 10.1055/a-2506-2675

Original Article

A Bedside-to-Bench-to-Bedside Journey to Advance Osteochondral Allograft Transplantation towards Biologic Joint Restoration

James L. Cook

¹Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri

²Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri

,

James P. Stannard

¹Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri

²Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri

,

Aaron M. Stoker

¹Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri

²Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri

,

Kylee Rucinski

¹Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri

²Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri

,

Brett D. Crist

¹Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri

²Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri

,

Cristi R. Cook

¹Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri

²Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri

,

Cory Crecelius

¹Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri

²Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri

,

Chantelle C. Bozynski

¹Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri

²Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri

,

Keiichi Kuroki

¹Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri

³Department of Veterinary Pathology, University of Missouri, Columbia, Missouri

,

Lisa A. Royse

¹Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri

²Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri

,

Renee Stucky

¹Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri

²Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri

,

Clark T. Hung

⁴Department of Biomedical Engineering, Columbia University, New York, New York

,

Matthew J. Smith

¹Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri

²Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri

,

Kyle M. Schweser

¹Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri

²Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri

,

Clayton W. Nuelle

¹Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri

²Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri

,

Steven DeFroda

¹Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri

²Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri

› Author Affiliations

Abstract

More than 70 million adults in the United States are impacted by osteoarthritis (OA). Symptomatic articular cartilage loss that progresses to debilitating OA is being diagnosed more frequently and earlier in life, such that a growing number of active patients are faced with life-altering health care decisions at increasingly younger ages. Joint replacement surgeries, in the form of various artificial arthroplasties, are reliable operations, especially for older (≥65 years), more sedentary patients with end-stage OA, but have major limitations for younger, more active patients. For younger adults and those who wish to remain highly active, artificial arthroplasties are associated with significantly higher levels of pain, complications, morbidity, dysfunction, and likelihood of revision. Unfortunately, non-surgical management strategies and surgical treatment options other than joint replacement are often not indicated and have not proven to be consistently successful for this large and growing population of patients. As such, these patients are often relegated to postpone surgery, take medications including opioids, profoundly alter their lifestyle, and live with pain and disability until artificial arthroplasty is more likely to meet their functional demands without high risk for early revision. As such, our research team set out to develop, test, and validate biologic joint restoration strategies that could provide consistently successful options for young and active patients with joint disorders who were not considered ideal candidates for artificial arthroplasty. In pursuit of this goal, we implemented a targeted bedside-to-bench-to-bedside translational approach to hypothesis-driven studies designed to address this major unmet need in orthopaedics by identifying and overcoming key clinical limitations and obstacles faced by health care teams and patients in realizing optimal outcomes after biologic joint restoration. The objective of this article is to condense more than two decades of rigorous patient-centered research aimed at optimizing osteochondral and meniscus allograft transplantation toward more consistently successful management of complex joint problems in young and active patients.

Keywords

knee - transplantation - osteoarthritis - osteochondral allograft - meniscus allograft

Full Text

References

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