Experimental results of donor site filling for autologous osteochondral mosaicplasty |
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| Institution: | 1. Orthopaedic and Trauma Department Uzsoki Hospital, Budapest, Hungary;2. Urology Department, Uzsoki Hospital, Budapest, Hungary;3. Semmelweis Medical School, Orthopaedic Clinic, Budapest, Hungary;4. Faculty of Veterinary Science, Small Animal Surgery Szent Istvań University, Budapest, Hungary;5. Faculty of Veterinary Science, Large Animal Surgery, Szent Istvań University, Budapest, Hungary;6. Department of Anatomy & Histology, University of Debrecen Medical School, Debrecen, Hungary;1. Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65, Tsurumai, Showa-ku, Nagoya, Aichi, 466-8550, Japan;2. Department of Orthopaedic Surgery, Kansai University of Welfare Sciences, 3-11-1, Asahigaoka, Kashihara, Osaka, 5820026, Japan;1. Harvard Combined Orthopaedic Residency Program (HCORP), Boston, MA;2. UCLA Medical Center, Los Angeles, CA;3. Brigham and Women’s Hospital, Harvard Medical School, Boston, MA;1. Ortho Kids Clinic, Ahmedabad, India;2. Indraprastha Apollo Hospital, New Delhi, India;3. Indraprastha Apollo Hospital, New Delhi, India;1. Research Support Center, Dokkyo Medical University, Mibu, Tochigi, Japan;2. Center for Regenerative Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan;3. Division of Biomedical Engineering, Research Institute, National Defense Medical College, Saitama, Japan;4. Department of Cardiovascular Medicine, Dokkyo Medical University, Mibu, Tochigi, Japan;5. Department of Cardiology, Koshigaya Hospital, Dokkyo Medical University, Koshigaya, Saitama, Japan;1. Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine 65, Tsurumai, Showa-ku, Nagoya, Aichi 466-8550, Japan;2. Department of Rehabilitation, Kansai University of Welfare Sciences 3-11-1, Asahigaoka, Kashiwara, Osaka 582-0026, Japan |
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| Abstract: | Purpose: Autologous osteochondral mosaicplasty has become a treatment option for focal chondral and osteochondral defects in recent years. Excessive postoperative bleeding from the donor site was reported as a possible complication of the procedure. The purpose of this study was to investigate different biodegradable materials for donor site filling, which could prevent excessive postoperative bleeding from these sites but would allow reasonable blood clot formation on the articular surfaces of donor tunnels. Type of Study: Basic science evaluation. Methods: In an experimental model, “donor site plugs” made from hydroxylapatite, carbon fiber, polyglyconate-B, compressed collagen, and 2 versions of polycaprolactones were used to fill the bony tunnels created by harvesting. These materials were tested in 100 knees of 50 German Shepherd dogs to determine the quality of the repair tissue formation on the surfaces of the harvesting holes filled by these materials. Arthroscopies of the dogs were performed at several intervals, from 4 weeks to 26 weeks, and macroscopic studies were performed on euthanized animals between 8 weeks and 30 weeks to evaluate donor site filling and coverage. Empty donor tunnels served as controls for the evaluation of the different filling materials. Results: All tested materials effectively decreased postoperative bleeding. Hydroxylapatite, carbon rods, polyglyconate-B, and melted polycaprolactone materials showed a good integration to the surrounding cancellous bone, but these fillings showed only a limited repair tissue formation, even at 30 weeks postoperatively. Second-look arthroscopy and histologic evaluation of necropsies showed the best fibrocartilage coverage after filling by compressed collagen. Technical details of the filling also had certain importance in the quality of the repair tissue formation. Conclusions: According to histologic results, compressed collagen appears to be a good material to fill donor tunnels of osteochondral graft harvest. This material is substituted gradually by bone formation and its articular surface can serve as an appropriate scaffold for fibrocartilage coverage created by the natural intrinsic repair process. |
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