Episode 59: Dr. William Bugbee: Osteochondral Allograft Transplantation (Part 1)

On today’s episode we’re focusing on osteochondral allograft transplantation or “OCA” with Dr. William Bugbee. We have some great articles for you that contribute well to our conversation on OCA, including allograft preparation and storage, graft choice, surgical technique, clinical outcomes of OCA and return to sport. 

We’ll start off our discussion today with an article authored by our guest, Dr. William Bugbee, from the May 2022 issue of AJSM titled “Fresh Osteochondral and Chondral Allograft Preservation and Storage Media: A Systematic Review of the Literature.” 

There was significant variability in experimental designs and incomplete reporting across the studies, so no real conclusions could be drawn regarding optimal storage conditions. While 60% of animal model studies suggest storage time may impact outcomes and 80% indicate inferior outcomes with frozen OCA compared to fresh OCA, the authors note that 75% of clinical studies reported no correlation between storage time and outcomes. So, we have a lot left to learn here.

Then, from the March 2022 issue of AJSM, we review an article titled “Association of Sex Mismatch Between Donor and Recipient With Graft Survivorship at 5 Years After OCA Transplantation.” Dr. Gomoll and colleagues at Brigham and Women’s reported that a significantly lower rate of graft survival was observed after different sex donor-recipient transplant compared to same sex donor-recipient OCA – 63% compared to 92%. Patients who received a donor-recipient sex-mismatch transplantation were 2.9X more likely to fail. Male donor to female recipient demonstrated the highest likelihood of failure compared to all other combinations.

We are joined today by Dr. William Bugbee, a board-certified orthopedic surgeon specializing in joint reconstruction and cartilage restoration at Scripps Clinic in La Jolla, California. Dr. Bugbee received his medical degree from UC San Diego and remained at UC San Diego for his orthopedic surgery residency.  He then went on to complete a fellowship in joint reconstruction at the Anderson Orthopaedic Research Institute. Dr. Bugbee has published extensively on the topic of osteochondral allograft transplantation, so we’re very excited that he is joining us today to share his expertise with all of you!