Tomasz L Nosewicz1, Mikel L Reilingh, Martin Wolny, C Niek van Dijk, Georg N Duda, Hanna Schell. 1. Julius Wolff Institute and Center for Musculoskeletal Surgery and Berlin-Brandenburg Center for Regenerative Therapies, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, Forum 4, Postbox 24, 13353, Berlin, Germany, t.nosewicz@gmail.com.
Abstract
PURPOSE: The influence of basal graft support combined to early loading following an osteochondral autograft procedure is unclear. It was hypothesized that bottomed grafts may allow for early mobilization by preventing graft subsidence and leading to better healing. METHODS: Osteochondral autografts were press fitted in the femoral condyles of 24 sheep (one graft per animal). In the unbottomed group (n = 12), a gap of 2 mm was created between graft and recipient bone base. In the bottomed group (n = 12), the graft firmly rested on recipient bone. Animals were allowed immediate postoperative weightbearing. Healing times were 3 and 6 months per group (n = 6 per subgroup). After killing, histological and histomorphometric analyses were performed. RESULTS: Unbottomed grafts at 3 months showed significantly more graft subsidence (P = 0.024), significantly less mineralized bone (P = 0.028) and significantly worse cartilage and subchondral bone plate healing (P = 0.034) when compared to bottomed grafts. At 6 months, no differences were seen. Compared to the native situation, unbottomed grafts showed significantly more graft subsidence (P = 0.024), whereas bottomed grafts did not. Cystic lesions were seen in both groups. Osteoclasts were closely related to the degree of bone remodelling. CONCLUSION: In the animal model, in the case of early loading, bottomed osteochondral autografts have less chance of graft subsidence. Evident subsidence negatively influences the histological healing process. In the osteochondral autograft procedure, full graft support should be aimed for. This may allow for early mobilization, diminish graft subsidence and improve long-term integration.
PURPOSE: The influence of basal graft support combined to early loading following an osteochondral autograft procedure is unclear. It was hypothesized that bottomed grafts may allow for early mobilization by preventing graft subsidence and leading to better healing. METHODS: Osteochondral autografts were press fitted in the femoral condyles of 24 sheep (one graft per animal). In the unbottomed group (n = 12), a gap of 2 mm was created between graft and recipient bone base. In the bottomed group (n = 12), the graft firmly rested on recipient bone. Animals were allowed immediate postoperative weightbearing. Healing times were 3 and 6 months per group (n = 6 per subgroup). After killing, histological and histomorphometric analyses were performed. RESULTS: Unbottomed grafts at 3 months showed significantly more graft subsidence (P = 0.024), significantly less mineralized bone (P = 0.028) and significantly worse cartilage and subchondral bone plate healing (P = 0.034) when compared to bottomed grafts. At 6 months, no differences were seen. Compared to the native situation, unbottomed grafts showed significantly more graft subsidence (P = 0.024), whereas bottomed grafts did not. Cystic lesions were seen in both groups. Osteoclasts were closely related to the degree of bone remodelling. CONCLUSION: In the animal model, in the case of early loading, bottomed osteochondral autografts have less chance of graft subsidence. Evident subsidence negatively influences the histological healing process. In the osteochondral autograft procedure, full graft support should be aimed for. This may allow for early mobilization, diminish graft subsidence and improve long-term integration.
Authors: B von Rechenberg; M K Akens; D Nadler; P Bittmann; K Zlinszky; A Kutter; A R Poole; J A Auer Journal: Osteoarthritis Cartilage Date: 2003-04 Impact factor: 6.576
Authors: Sudheer Reddy; David I Pedowitz; Selene G Parekh; Brian J Sennett; Enyi Okereke Journal: Am J Sports Med Date: 2006-09-06 Impact factor: 6.202
Authors: Niels B Kock; Gerjon Hannink; Albert van Kampen; Nico Verdonschot; Job L C van Susante; Pieter Buma Journal: Knee Surg Sports Traumatol Arthrosc Date: 2011-09-09 Impact factor: 4.342
Authors: Niels B Kock; José M H Smolders; Job L C van Susante; Pieter Buma; Albert van Kampen; Nico Verdonschot Journal: Knee Surg Sports Traumatol Arthrosc Date: 2008-05 Impact factor: 4.342
Authors: Ethan J Fraser; Mark C Harris; Marcelo P Prado; John G Kennedy Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-05-12 Impact factor: 4.342
Authors: Jorge Chahla; Betina B Hinckel; Adam B Yanke; Jack Farr; William D Bugbee; James L Carey; Brian J Cole; Dennis C Crawford; James E Fleischli; Alan Getgood; Andreas H Gomoll; Simon Gortz; Allan E Gross; Deryk G Jones; Aaron J Krych; Christian Lattermann; Bert R Mandelbaum; Peter R Mandt; Tom Minas; Raffy Mirzayan; Timothy S Mologne; John D Polousky; Matthew T Provencher; Scott A Rodeo; Oleg Safir; Seth Lawrence Sherman; Eric D Strauss; Sabrina M Strickland; Christopher J Wahl; Riley J Williams Journal: Orthop J Sports Med Date: 2020-03-26