A cadaveric analysis of contact stress restoration after osteochondral transplantation of a cylindrical cartilage defect |
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Authors: | Niels B Kock José M H Smolders Job L C van Susante Pieter Buma Albert van Kampen Nico Verdonschot |
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Institution: | (1) Orthopaedic Research Laboratory, Department of Orthopaedics, Radboud University Nijmegen Medical Centre, P.O. Box 9101, Nijmegen, The Netherlands;(2) Department of Orthopaedics, Rijnstate Hospital, Postbus 9555, 6800 TA Arnhem, The Netherlands;(3) Department of Orthopaedics, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands |
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Abstract: | 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. |
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Keywords: | Biomechanics Cartilage Articular/pathology Humans Knee Joint/Surgery Pressure Surface Properties Transplantation Autologous Weight-bearing |
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