A cadaveric analysis of contact stress restoration after osteochondral transplantation of a cylindrical cartilage defect

Osteochondral transplantation is a successful treatment for full-thickness cartilage defects, which without treatment would lead to early osteoarthritis. Restoration of surface congruency and stability of the reconstruction may be jeopardized by early mobilization. To investigate the biomechanical e...

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Bibliographic Details
Published in:Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2008-05, Vol.16 (5), p.461-468
Main Authors: Kock, Niels B., Smolders, José M. H., van Susante, Job L. C., Buma, Pieter, van Kampen, Albert, Verdonschot, Nico
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Arthritis
Biomechanical Phenomena
Biomechanics
Cadaver
Cadavers
Cartilage
Cartilage - transplantation
Defects
Humans
Knee
Knee - surgery
Medicine
Medicine & Public Health
Orthopedic Procedures - methods
Orthopedics
Osteoarthritis
Sensors
Stress, Mechanical
Transplants & implants
Weight-Bearing
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Summary:Osteochondral transplantation is a successful treatment for full-thickness cartilage defects, which without treatment would lead to early osteoarthritis. Restoration of surface congruency and stability of the reconstruction may be jeopardized by early mobilization. To investigate the biomechanical effectiveness of osteochondral transplantation, we performed a standardized osteochondral transplantation in eight intact human cadaver knees, using three cylindrical plugs on a full-thickness cartilage defect, bottomed on one condyle, unbottomed on the contralateral condyle. Surface pressure measurements with Tekscan pressure transducers were performed after five conditions. In the presence of a defect the border contact pressure of the articular cartilage defect significantly increased to 192% as compared to the initially intact joint surface. This was partially restored with osteochondral transplantation (mosaicplasty), as the rim stress subsequently decreased to 135% of the preoperative value. Following weight bearing motion two out of eight unbottomed mosaicplasties showed subsidence of the plugs according to Tekscan measurements. This study demonstrates that a three-plug mosaicplasty is effective in restoring the increased border contact pressure of a cartilage defect, which may postpone the development of early osteoarthritis. Unbottomed mosaicplasties may be more susceptible for subsidence below flush level after (unintended) weight bearing motion.
ISSN:0942-2056
1433-7347
DOI:10.1007/s00167-008-0494-1