Ep. 114 Exploring Osteochondral Allografts for Knee Injuries with Dr. Sachin Allahabadi

When does a knee cartilage defect need more than a clean-up, and how do you decide on the best repair? On this episode of BackTable Bone & Sports, Dr. Larry Balle welcomes orthopedic sports surgeon Dr. Sachin Allahabadi for a practical tour of cartilage restoration. Together they explain what articular cartilage is, why it rarely heals on its own, and how to distinguish focal chondral defects from diffuse arthritis. The discussion covers the full spectrum of treatment, from chondroplasty and microfracture to cell-based restoration, osteochondral autograft, and allograft transplantation. --- Get the BackTable apphttps://www.backtable.com/app --- Timestamps 00:00 - Introduction04:39 - Cartilage Structure and Focal Defects13:37 - Cartilage Healing Biology16:51 - Evolution of Cartilage Repair Techniques24:04 - Candidate Selection and Defect Characteristics29:06 - Bone Marrow Edema and Offloading33:46 - Osteochondral Autograft and Donor Sites39:18 - Alignment, Meniscus, and Ligament Correction45:31 - Cell Based Repair Indications and Procedure Durability51:11 - Defect Sizing and Allograft Matching59:29 - Rehabilitation and Orthobiologic Graft Integration01:09:59 - Takeaways and Misconceptions01:14:21 - Closing Remarks --- More about this episode Dr. Allahabadi discusses how to select the right patients for different cartilage procedures, including how defect size, alignment, meniscus status, and ligament stability all factor into the decision. They review advances in cartilage repair techniques, the process of storing and matching fresh donor tissue, and the use of bone marrow aspirate concentrate to promote graft integration. The conversation also addresses the durability of allografts in real-world practice, setting realistic expectations with patients, the importance of referral to high-volume surgeons, and why thoughtful clinical decision-making is often more challenging than the procedure itself. --- Resources Allahabadi S, Quigley R, Frazier L, Joyce K, Cole BJ. Outcomes and Return to Sport After Knee Osteochondral Allograft Transplant in Professional Athletes. Orthop J Sports Med. 2024.https://pubmed.ncbi.nlm.nih.gov/38410170/ Elias TJ, Allahabadi S, Haneberg EC, et al. Osteochondral Allograft Reaming Significantly Affects Chondrocyte Viability. Am J Sports Med. 2024. https://pubmed.ncbi.nlm.nih.gov/39186448/ Allahabadi S, Haneberg EC, Elias TJ, McMorrow KJ, et al. Osteochondral Allografts: Pearls to Maximize Biologic Healing and Clinical Success. Arthrosc Tech. 2023. https://pubmed.ncbi.nlm.nih.gov/38196872/ --- BackTable Bone & Sports is the go-to podcast for orthopedic surgeons, sports medicine docs, pain specialists, and MSK radiologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app