BlueCross BlueShield of Tennessee Medical Policy Manual

Osteochondral Allografting


Osteochondral allografting is one of several types of cartilage transplant procedures used in the treatment of individuals with symptomatic, disabling cartilage injury or disease. The literature indicates that osteochondral allografting can provide significant relief of pain and improved joint function for individuals with focal articular cartilage defects due to trauma or osteochondritis dissecans. The procedure involves the transplantation of a piece of articular cartilage and attached subchondral bone to a damaged region of the articular surface of a joint. The goal is to provide viable chondrocytes and supporting bone that will be sufficient to maintain the cartilage matrix and thereby relieve pain and reduce further damage to the articular surface of the joint. Alternatives to osteochondral allografting include abrasion chondroplasty, osteotomy and total knee replacement, arthrodesis (fusion) or prosthetic arthroplasty of the ankle.


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The literature does not include enough randomized control studies to demonstrate the benefit of using osteochondral allografting for treating any other joint problems except those of the articular surfaces of the knee.


BlueCross BlueShield Association. Medical Policy Reference Manual. (6:2014). Autografts and allografts in the treatment of focal articular cartilage lesions (7.01.78). Retrieved August 5, 2014 from BlueWeb. (54 articles and/or guidelines reviewed)

Caldwell, P. E., 3rd, & Shelton, W. R. (2005). Indications for allografts. Orthopedic Clinics of North America, 36 (4), 459 - 467. (Level 5 Evidence)

Ghazavi, M. T., Pritzker, K. P., Davis, A. M., & Gross, A. E. (1997). Fresh osteochondral allografts for post-traumatic osteochondral defects of the knee. Journal of Bone and Joint Surgery. British Volume, 79 (6), 1008 - 1013. (Level 4 Evidence)

Gross, A., Kim, W., Las Heras, F., Backstein, D., Safir, O., & Pritzker,K. (2008). Fresh osteochondral allografts for posttraumatic knee defects: long-term followup. Clinical Orthopedic Related Research, 466 (8), 1863 - 1870. (Level 4 Evidence)

Jeng, C., Kadakia, A., White, K., Myerson, M. (2008). Fresh osteochondral total ankle allograft transplantation for the treatment of ankle arthritis. Foot Ankle International, 29 (6), 554 - 560. (Level 4 Evidence)

Turtel, A. (2005, March). Osteochondral ghrafting of articular cartilage injuries. Retrieved February 24, 2009 from

U.S. Food and Drug Administration. (2005, February). Center for Devices and Radiological Health. 510(k) Premarket notification database. K043421. Retrieved January 26, 2012 from

Winifred S. Hayes. Medical Technology Directory. (2000, September, last update March 15, 2006). Osteochondral allografting for the knee. Retrieved January 27, 2012 from (22 articles and/ or guidelines reviewed)




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