HOME HELP CONTACT US SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Sign In to gain access to subscriptions and/or personal tools.

This Article Full Text Full Text (PDF) All Versions of this Article: 32/8/1842    most recent 0363546504264895v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (8) Citing Articles via Google Scholar Google Scholar Articles by Huang, F. S. Articles by Clark, J. M. Search for Related Content PubMed PubMed Citation Articles by Huang, F. S. Articles by Clark, J. M. Related Collections Chondral/cartilage Animal studies

Effects of Small Incongruities in a Sheep Model of Osteochondral Autografting

Fred S. Huang, MD^*, Peter T. Simonian, MD, Anthony G. Norman and John M. Clark, MD, PhD^,

From the ^* Valley Orthopaedic Associates, Renton, Washington, Simonian Sports Medicine Clinic, Fresno, California, and Department of Orthopaedics and Sports Medicine, University of Washington, Seattle, Washington

Address correspondence to John M. Clark, MD, PhD, Department of Orthopaedics and Sports Medicine, University of Washington, 1959 NE Pacific, Box 356500, Seattle, WA 98195-6500 (e-mail: drclark{at}u.washington.edu).

Background: Exact reconstruction of an osteochondral defect by autogenous transplantation (mosaicplasty) is difficult given the variation in joint surface contour. Clinical and experimental studies do not show the extent to which incongruity can be tolerated in autografting.

Hypothesis: Grafted articular cartilage will hypertrophy to correct the incongruity created by recession of the transplanted surface.

Study Design: Controlled laboratory study.

Methods: To test the response of grafts to incongruities, osteochondral autografts were transplanted from the trochlea to the femoral condyle in adult male sheep stifle joints. In groups of 6 animals, graft surfaces were placed flush, countersunk 1 mm or countersunk 2 mm, then histologically analyzed 6 weeks after surgery. Cartilage thickness, condition of the articular surfaces, and preservation of hyaline characteristics were the primary features compared.

Results: Bony union, vascularization, and new bone formation were present in all grafts. Cartilage-to-cartilage healing did not occur. In flush specimens, cartilage changed minimally in thickness and histologic architecture. The specimens countersunk 1 mm demonstrated significant cartilage thickening (54.7% increase, P <.05). Chondrocyte hyperplasia, tidemark advancement, and vascular invasion occurred at the chondroosseous junction, and the surface remained smooth. Cartilage necrosis and fibrous overgrowth were observed in all grafts countersunk 2 mm.

Conclusions: Minimally countersunk autografts possess a capacity for remodeling that can correct initial incongruities while preserving hyaline characteristics. Grafts placed deeper do not restore the contour or composition of the original articular surface.

Clinical Relevance: If preservation of normal hyaline cartilage is the objective, thin grafted articular cartilage can remodel, but the tolerance for incongruity is limited and probably less than that reported for an intra-articular fracture.

Key Words: articular cartilage • knee • autografting • transplantation

This article has been cited by other articles:

				S. Patil, W. Butcher, D. D. D'Lima, N. Steklov, W. D. Bugbee, and H. R. Hoenecke Effect of Osteochondral Graft Insertion Forces on Chondrocyte Viability Am. J. Sports Med., September 1, 2008; 36(9): 1726 - 1732. [Abstract] [Full Text] [PDF]

				P. E. Scranton Jr, C. C. Frey, and K. S. Feder Outcome of osteochondral autograft transplantation for type-V cystic osteochondral lesions of the talus J Bone Joint Surg Br, May 1, 2006; 88-B(5): 614 - 619. [Abstract] [Full Text] [PDF]