Implantation of fresh OCA resulted in consistently good (and intact) cartilage repair outcomes with high cartilage cellularity, whereas 4°C stored OCA had variable results, and the cartilage had decreased cellularity and was somewhat susceptible to degeneration. Frozen OCA exhibited clear progression toward failure (erosion), with loss of chondrocytes, reduced proteoglycan content and cartilage stiffness, and associated surface and/or bone collapse.