An investigation of 2 techniques for optimizing joint surface congruency using multiple cylindrical osteochondral autografts

• Published in: Arthroscopy Vol. 17; no. 1; pp. 50 - 55
• Main Authors: Pearce, Simon G., Hurtig, Mark B., Clarnette, Richard, Kalra, Manpreet, Cowan, Bryce, Miniaci, Anthony
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Elsevier Inc 01-01-2001; Elsevier
• Subjects: Animals; Articular cartilage; Biological and medical sciences; Cartilage, Articular - diagnostic imaging; Cartilage, Articular - pathology; Cartilage, Articular - transplantation; Female; Femur - diagnostic imaging; Femur - pathology; Femur - surgery; Medical sciences; Osseointegration; Osteochondral grafts; Radiographic Image Enhancement; Resurfacing; Sheep; Surface Properties; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Technology. Biomaterials. Equipments; Transplantation, Autologous; Treatment Outcome; Weight-Bearing; Osteochondral grafts; Articular cartilage; Resurfacing; Knee; Animal model; Hindlimb; Prognosis; Diseases of the osteoarticular system; Autograft; Graft; Experimental surgery; Ungulata; Congruence; Multiple; Substance loss; Joint; Contact surface; Cylinder; Vertebrata; Orthopedic surgery; Chondropathy; Mammalia; Treatment; Sheep; Artiodactyla; Technique; Comparative study
• ISSN: 0749-8063; 1526-3231
• DOI: 10.1053/jars.2001.19966

Purpose: To compare 2 techniques for optimizing joint congruency for miniature osteochondral autografting in the knee: intrinsic postoperative forces acting on overdrilled autografts protruding from the femur versus alignment by a surgeon at the time of grafting. Type of Study: Controlled animal model experiment. Methods: A full-thickness cartilage defect was created on the weight-bearing surface of the medial femoral condyle of 13 mature sheep. Three 4.5 × 10 mm cylindrical autografts were inserted into 14-mm deep recipient holes such that the grafts were held in place by side-wall friction alone. One treatment group received grafts that were delivered flush with the surrounding cartilage and the second group received grafts that were left 2-mm proud of the joint surface. Results: Three months postoperatively, the proud grafts had been repositioned by weight bearing but perigraft fissuring and fibroplasia, and subchondral cavitations were serious complications. It is suspected that these complications were caused by excessive motion between the graft and recipient site in the proud grafts. Conclusions: Grafts should be delivered flush with the joint surface when performing osteochondral transfers to avoid graft micromotion and the consequent interference with graft integration and function.
Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 17, No 1 (January), 2001: pp 50–55