Implementation of a Fresh Osteochondral Allograft Protocol for the Knee: A Case Series from Türkiye

Objective: This retrospective case series aimed to establish a standardized protocol for the procurement, processing, and surgical application of fresh osteochondral allografts (OCA) in Türkiye and to report the early clinical outcomes of this biological salvage treatment for knee cartilage defects. Methods: Ten fresh OCA transplantations were performed between July 2019 and June 2024, with a mean follow-up of 26.1 months. Patients were evaluated using the International Knee Documentation Committee (IKDC) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), and a 10-cm Visual Analog Scale (VAS) for knee pain. Magnetic resonance imaging was obtained at >12 months postoperatively to assess graft survival. Results: The mean patient age was 30.3 ± 5.7 years (6 males, 4 females). The mean graft area was 5.1 cm² (range: 2.5-7.5 cm²). The IKDC scores improved from 37.5 to 65.4, KOOS scores from 38 to 69.6, and VAS scores from 6 to 1.6. Magnetic resonance imaging evaluation beyond 12 months showed no evidence of graft failure. Conclusion: Fresh OCA represents a reliable and effective treatment option for knee cartilage defects. Establishing its availability in Türkiye has the potential to broaden access, enabling more surgeons to adopt the technique and more patients to benefit from this biological salvage procedure. Cite this article as: Meriç G, Eren O, Kocadal O, Ateş U. Implementation of a fresh osteochondral allograft protocol for the knee: a case series from Türkiye. Acta Orthop Traumatol Turc., 2026, 60(1), 0310, doi:10.5152/j.aott.2026.25310