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Osteochondral allograft and autograft transplantation

Status: Decision completed

View findings and decision

Osteochondral Autograft Transfer System surgery (OATS) was first reviewed by the HTCC in 2011.

In 2018, a review of OATS medical literature was performed to determine if evidence published since the 2011 review was likely to change the original decision.

Policy context

Osteochondral Autograft Transfer System surgery is a graft procedure that uses one or more "plugs" of healthy cartilage to fill in damaged areas. It can be done as an open or arthroscopic procedure, and is sometimes combined with other joint operations such as arthroscopic debridement or ACL repair. The grafted cartilage is harvested from another area within the joint, and the harvest site as well as the repair site need to heal properly, so a period of physical therapy is required after the operation.

Osteochondral Allograft Transplant Surgery is a graft procedure similar to Osteochondral Autograft Transfer System, but using graft material from preserved cadaver cartilage. There is some indication that allograft cartilage does not integrate as well, and transplantation involves some risk of infection. However, adequate healthy cartilage tissue is not always available within the joint under repair. Mosaicplasty is a more generic term that covers either Osteochondral autograft or allograft, open or arthroscopic.

Primary criteria ranking

  • Safety = Medium
  • Efficacy = High
  • Cost = Low

Assessment timeline

  • Draft report published: September 14, 2011
  • Public comment period: September 14 - September 30, 2011
  • Final report published: October 18, 2011
  • HTCC public meeting: November 18, 2011