Allograft tissue is known to decrease donor site morbidity and allow for management of conditions that have few other treatment alternatives like a completely meniscectomized knee and large osteochondral lesions. Despite this though, the use of allograft tissue in Europe right now is limited by supply as well as by political and regulatory issues and the European Society for Sports Traumatology, Knee Surgery and Arthoscopy (ESSKA) European Allograft Initiative wants to change that.
Improving Allograft Availability Focus of ESSKA Initiative
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Secondary#orthopedics#allografttissue
Tim Spalding, FRCS (Orth), FRSCS (ED), MB BS, a sports medicine surgeon at the Nuffield Health Warwickshire Hospital in the United Kingdom and chairman of the ESSKA Arthroscopy Committee is leading the drive for more data on allograft tissue use in order to justify its increased use and availability in Europe.
The focus of the initiative includes ligaments, osteochondral allografts and meniscal grafts, predominantly in the knee but also in other joints where appropriate.
Several ESSKA committees including the Arthroscopy Committee, the Basic Science Committee and the Cartilage Committee, along with other scientific organizations, have been tackling the different goals of the initiative which have included collecting data on the basic science of allograft tissue processing, reviewing current clinical evidence of the efficacy of allograft tissue, and defining clear indications and contra indications for the clinical use of this tissue.
In their final Technology Assessment Report, they will establish the cost-effectiveness of treatment with allograft tissue. Spalding and his colleagues hope to provide the justification needed to ease tissue restrictions and make it easier for surgeons in the European Union to access U.S. allograft tissue.
The results of this cost-effectiveness study will be available and presented at the ESSKA Congress in Glasgow, Scotland, from May 9, 2018 to May 12, 2018. Find out more information here.
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This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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