Synthetic implants for the repair of osteochondral defects of the medial femoral condyle: A biomechanical and histological evaluation in the rabbit knee

Background: Previous work has demonstrated that patients with cartilage defects of the knee benefit from arthroscopic transplantation of autologous synovial mesenchymal stem cells (MSCs) in terms of magnetic resonance imaging (MRI), qualitative histologic findings, and Lysholm score. However, the effectiveness was limited by the number of cells obtained, so large-sized defects (>500 mm2) were not investigated. The use of MSC aggregates may enable treatment of larger defects by increasing the number of MSCs adhering to the cartilage defect. Purpose: To investigate whether transplantation of aggregates of autologous synovial MSCs with 2-step surgery could promote articular cartilage regeneration in microminipig osteochondral defects. Study Design: Controlled laboratory study. Methods: Synovial MSCs derived from a microminipig were examined for in vitro colony-forming and multidifferentiation abilities. An aggregate of 250,000 synovial MSCs was formed with hanging drop culture, and 16 aggregates (for each defect) were implanted on both osteochondral defects (6 × 6 × 1.5 mm) created in the medial femoral condyle and femoral groove (MSC group). The defects in the contralateral knee were left empty (control group). The knee joints were evaluated at 4 and 12 weeks by macroscopic findings and histology. MRI T1rho mapping images were acquired at 12 weeks. For cell tracking, synovial MSCs were labeled with ferucarbotran before aggregate formation and were observed with MRI at 1 week. Results: Synovial MSCs showed in vitro colony-forming and multidifferentiation abilities. Regenerative cartilage formation was significantly better in the MSC group than in the control group, as indicated by International Cartilage Repair Society score (macro), modified Wakitani score (histology), and T1rho mapping (biochemical MRI) in the medial condyle at 12 weeks. Implanted cells, labeled with ferucarbotran, were observed in the osteochondral defects at 1 week with MRI. No significant difference was noted in the modified Wakitani score at 4 weeks in the medial condyle and at 4 and 12 weeks in the femoral groove. Conclusion: Transplantation of autologous synovial MSC aggregates promoted articular cartilage regeneration at the medial femoral condyle at 12 weeks in microminipigs. Clinical Relevance: Aggregates of autologous synovial MSCs could expand the indications for cartilage repair with synovial MSCs.

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Healing of Osteochondral Defects via Endochondral Ossification in an Ovine Model

Cartilage ◽

10.1177/1947603517713818 ◽

2017 ◽

Vol 10 (1) ◽

pp. 94-101 ◽

Cited By ~ 4

Author(s):

Helen Lydon ◽

Alan Getgood ◽

Frances M. D. Henson

Keyword(s):

Endochondral Ossification ◽

Distal Femur ◽

Femoral Condyle ◽

Medial Femoral Condyle ◽

Fracture Repair ◽

Joint Surface ◽

Osteochondral Defects ◽

Healing Tissue ◽

Defect Repair ◽

Female Sheep

Objective The objective of this study was to describe the mechanism of healing of osteochondral defects of the distal femur in the sheep, a commonly used translational model. Information on the healing mechanism be useful to inform the design of tissue engineering devices for joint surface defect repair. Design A retrospective study was conducted examining 7-mm diameter osteochondral defects made in the distal medial femoral condyle of 40 adult female sheep, comprising control animals from 3 separate structures. The healing of the defects was studied at post mortem at up to 26 weeks. Results Osteochondral defects of the distal femur of the sheep heal through endochondral ossification as evidenced by chondrocyte hypertrophy and type X collagen expression. Neocartilage is first formed adjacent to damaged cartilage and then streams over the damaged underlying bone before filling the defect from the base upward. No intramembranous ossification or isolated mesenchymal stem cell aggregates were detected in the healing tissue. No osseous hypertrophy was detected in the defects. Conclusions Osteochondral defects of the medial femoral condyle of the sheep heal via endochondral ossification, with neocartilage first appearing adjacent to damaged cartilage. Unlike the mechanism of healing in fracture repair, neocartilage is eventually formed directly onto damaged bone. There was most variability between animals between 8 and 12 weeks postsurgery. These results should be considered when designing devices to promote defect healing.

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Durability of artificial implants for repair of osteochondral defects of the medial femoral condyle in rabbits

Biomaterials ◽

10.1016/0142-9612(94)90163-5 ◽

1994 ◽

Vol 15 (9) ◽

pp. 657-664 ◽

Cited By ~ 18

Author(s):

Karola Messner

Keyword(s):

Femoral Condyle ◽

Medial Femoral Condyle ◽

Osteochondral Defects

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Evaluation of N-Butyl 2-Cyanoacrylate for the Fixation of Osteochondral Fractures

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1633243 ◽

1991 ◽

Vol 4 (01) ◽

pp. 11-15 ◽

Cited By ~ 1

Author(s):

D. N. Aron ◽

G. N. Rowland ◽

P. T. Purinton ◽

R. E. Roberts ◽

Mary Jean Gorse

Keyword(s):

Articular Cartilage ◽

Femoral Condyle ◽

Medial Femoral Condyle ◽

Bone Union ◽

Histological Evaluation ◽

Cyanoacrylate Adhesive ◽

Surface Irregularities ◽

Primary Bone ◽

Osteochondral Fractures ◽

Femoral Condyles

SummaryUnstable osteochondral fractures were created on one medial femoral condyle of 39 adult rabbits. The fractures were repaired with n-butyl cyanoacrylate adhesive in 21 rabbits. The remaining fractures were not repaired. Radiographs were made at frequent intervals. The rabbits were euthanatized at 4, 6, 8, 12, and 16 weeks after surgery. The alignment and stability of the osteochondral fragments were assessed, followed by collection of sections of the medial femoral condyles for histological evaluation. Radiologically, the adhesive repaired fractures healed by primary bone union. The adhesive repaired fractures were significantly (p <0.05) better aligned and more stable than the non-repaired fractures at necropsy. Histologically, there was healing of the subchondral fracture lines of adhesive repaired fractures. The articular cartilage overlying the healing fragments was normal or had only minor surface irregularities.

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Histological evaluation of a free medial femoral condyle flap at 21 months

Microsurgery ◽

10.1002/micr.22158 ◽

2013 ◽

Vol 33 (7) ◽

pp. 567-571 ◽

Cited By ~ 4

Author(s):

Benjamin J. Brown ◽

James P. Higgins ◽

Ryan D. Katz

Keyword(s):

Femoral Condyle ◽

Medial Femoral Condyle ◽

Histological Evaluation

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High tibial osteotomy combined with cancellous bone graft and osteochondral autograft transplantation in a patient with massive osteochondral defects in the medial femoral condyle

Journal of Orthopaedic Surgery ◽

10.1177/2309499016685016 ◽

2017 ◽

Vol 25 (1) ◽

pp. 230949901668501

Author(s):

Takehiko Matsushita ◽

Shu Watanabe ◽

Daisuke Araki ◽

Tomoyuki Matsumoto ◽

Koji Takayama ◽

...

Keyword(s):

Bone Graft ◽

High Tibial Osteotomy ◽

Cancellous Bone ◽

Femoral Condyle ◽

Medial Femoral Condyle ◽

Tibial Osteotomy ◽

Osteochondral Defects ◽

Cancellous Bone Graft ◽

Osteochondral Autograft ◽

Osteochondral Autograft Transplantation

Treatment of massive osteochondral defects of the medial femoral condyle is challenging. A 46-year-old man who had a medial femoral condyle fracture on his left knee underwent osteosynthesis in a hospital, but the pain remained and the patient was referred to our hospital 8 months after the surgery. Radiographs showed a varus alignment of the leg, and magnetic resonance image showed a massive necrotic area in the medial femoral condyle. The patient received high tibial osteotomy (HTO) combined with iliac cancellous bone graft and an osteochondral autograft transplantation. Pain and the knee function markedly improved 2 years after the surgery. A second look arthroscopy showed a well-covered bone graft site with cartilaginous tissue and a well-integrated osteochondral plug. HTO combined with cancellous bone autograft and osteochondral autograft transplantation could be an effective treatment for patients presenting with a varus knee deformity associated with massive osteochondral defects in the medial femoral condyle.

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Vascularized Medial Femoral Condyle Periosteal Bone Grafts in the Treatment of Long-Standing Non-Union

Journal of Reconstructive Microsurgery ◽

10.1055/s-2006-958667 ◽

2007 ◽

Vol 22 (08) ◽

Author(s):

Umar Choudry ◽

Zeynep Karacor ◽

Steven Moran

Keyword(s):

Femoral Condyle ◽

Bone Grafts ◽

Medial Femoral Condyle ◽

Non Union

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Effect of Systemic Zoledronic Acid Dosing Regimens on Bone Regeneration in Osteoporotic Rats

Applied Sciences ◽

10.3390/app11041906 ◽

2021 ◽

Vol 11 (4) ◽

pp. 1906

Author(s):

Marwa Y. Shaheen ◽

Amani M. Basudan ◽

Abdurahman A. Niazy ◽

Jeroen J. J. P. van den Beucken ◽

John A. Jansen ◽

...

Keyword(s):

Bone Graft ◽

Bone Grafting ◽

Femoral Condyle ◽

Bone Defects ◽

Histological Evaluation ◽

Favorable Effect ◽

Osteoporotic Bone ◽

Bovine Bone ◽

Graft Placement ◽

Regeneration Of Bone

The aim of this study was to evaluate the regeneration of bone defects created in the femoral condyle of osteoporotic rats, following intravenous (IV) zoledronate (ZA) treatment in three settings: pre-bone grafting (ZA-Pre), post-bone grafting (ZA-Post), and pre- plus post-bone grafting (ZA-Pre+Post). Twenty-four female Wistar rats were ovariectomized (OVX). After 12 weeks, bone defects were created in the left femoral condyle. All defects were grafted with a particulate inorganic cancellous bovine bone substitute. ZA (0.04 mg/kg, weekly) was administered to six rats 4 weeks pre-bone graft placement. To another six rats, ZA was given post-bone graft placement creation and continued for 6 weeks. Additional six rats received ZA treatment pre- and post-bone graft placement. Control animals received weekly saline intravenous injections. At 6 weeks post-bone graft placement, samples were retrieved for histological evaluation of the bone area percentage (BA%) and remaining bone graft percentage (RBG%). BA% for ZA-Pre (50.1 ± 3.5%) and ZA-Post (49.2 ± 8.2%) rats was significantly increased compared to that of the controls (35.4 ± 5.4%, p-value 0.031 and 0.043, respectively). In contrast, ZA-Pre+Post rats (40.7 ± 16.0%) showed similar BA% compared to saline controls (p = 0.663). For RBG%, all experimental groups showed similar results ranging from 36.3 to 47.1%. Our data indicate that pre- or post-surgical systemic IV administration of ZA improves the regeneration of bone defects grafted with inorganic cancellous bovine-bone particles in osteoporotic bone conditions. However, no favorable effect on bone repair was seen for continued pre- plus post-surgical ZA treatment.

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