scholarly journals Simple geometry tribological study of osteochondral graft implantation in the knee

2018 ◽  
Vol 232 (3) ◽  
pp. 249-256 ◽  
Author(s):  
Philippa Bowland ◽  
Eileen Ingham ◽  
John Fisher ◽  
Louise M Jennings
Keyword(s):  
Knee Joint ◽  
Articular Surface ◽  
Cartilage Damage ◽  
Surface Damage ◽  
Negative Control ◽  
Osteochondral Allograft ◽  
Cartilage Defects ◽  
Osteochondral Grafts ◽  
Osteochondral Repair ◽  
Simple Geometry

Robust preclinical test methods involving tribological simulations are required to investigate and understand the tribological function of osteochondral repair interventions in natural knee tissues. The aim of this study was to investigate the effects of osteochondral allograft implantation on the local tribology (friction, surface damage, wear and deformation) of the tissues in the natural knee joint using a simple geometry, reciprocating pin-on-plate friction simulator. In addition, the study aimed to assess the ability of osteochondral grafts to restore a low surface damage, deformation and wear articulation when compared to the native state. A method was developed to characterise and quantify surface damage wear and deformation of the opposing cartilage-bone pin surface using a non-contacting optical profiler (Alicona Infinite Focus). Porcine 12 mm diameter cartilage-bone pins were reciprocated against bovine cartilage-bone plates that had 6 mm diameter osteochondral allografts, cartilage defects or stainless steel pins (positive controls) inserted centrally. Increased levels of surface damage with changes in geometry were not associated with significant increases in the coefficient of dynamic friction. Significant damage to the opposing cartilage surface was observed in the positive control groups. Cartilage damage, deformation and wear (as measured by change in geometry) in the xenograft (2.4 mm3) and cartilage defect (0.99 mm3) groups were low and not significantly different (p > 0.05) compared to the negative control in either group. The study demonstrated the potential of osteochondral grafts to restore the congruent articular surface and biphasic tribology of the natural joint. An optical method has been developed to characterise cartilage wear, damage and deformation that can be applied to the tribological assessment of osteochondral grafts in a whole natural knee joint simulation model.

scholarly journals Beneficial Storage Effects of Epigallocatechin-3-O-Gallate on the Articular Cartilage of Rabbit Osteochondral Allografts

2009 ◽  
Vol 18 (5-6) ◽  
pp. 505-512 ◽  
Author(s):  
Jung Yoon Bae ◽  
Kazuaki Matsumura ◽  
Shigeyuki Wakitani ◽  
Amu Kawaguchi ◽  
Sadami Tsutsumi ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Disease Transmission ◽  
Culture Medium ◽  
Clinical Success ◽  
Osteochondral Allograft ◽  
Cartilage Defects ◽  
Clinical Effects ◽  
Normal Cells ◽  
Osteochondral Grafts ◽  
Osteochondral Allografts

A fresh osteochondral allograft is one of the most effective treatments for cartilage defects of the knee. Despite the clinical success, fresh osteochondral allografts have great limitations in relation to the short storage time that cartilage tissues can be well-preserved. Fresh osteochondral grafts are generally stored in culture medium at 4°C. While the viability of articular cartilage stored in culture medium is significantly diminished within 1 week, appropriate serology testing to minimize the chances for the disease transmission requires a minimum of 2 weeks. (–)-Epigallocatechin-3- O-gallate (EGCG) has differential effects on the proliferation of cancer and normal cells, thus a cytotoxic effect on various cancer cells, but a cytopreservative effect on normal cells. Therefore, a storage solution containing EGCG might extend the storage duration of articular cartilages. Rabbit osteochondral allografts were performed with osteochondral grafts stored at 4°C in culture medium containing EGCG for 2 weeks and then the clinical effects were examined with macroscopic and histological assessment after 4 weeks. The cartilaginous structure of an osteochondral graft stored with EGCG was well-preserved with high cell viability and glycosaminoglycan (GAG) content of the extracellular matrix (ECM). After an osteochondral allograft, the implanted osteochondral grafts stored with EGCG also provided a significantly better retention of the articular cartilage with viability and metabolic activity. These data suggest that EGCG can be an effective storage agent that allows long-term preservation of articular cartilage under cold storage conditions.

scholarly journals Treatment outcomes of patients with knee hyaline cartilage damages using osteoperforative methods

2021 ◽  
Vol 9 (4) ◽  
pp. 397-406
Author(s):  
Sergei V. Chebotarev ◽  
Vladimir V. Khominets ◽  
Dmitry A. Zemlyanoy ◽  
Lidiya I. Kalyuzhnaya ◽  
Aleksej S. Grankin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Knee Joint ◽  
Treatment Outcomes ◽  
Hyaline Cartilage ◽  
Cartilage Damage ◽  
Treatment Method ◽  
Postoperative Treatment ◽  
Cartilage Defects ◽  
Military Medical Academy ◽  
Cartilage Injuries

BACKGROUND: The treatment of traumatic and degenerative cartilage damage is one of the largest areas in orthopedic practice, and the therapy success remains limited. AIM: To analyze the results of surgical treatment of patients with traumatic and degenerative injuries of the knee joint hyaline cartilage using debridement and osteoperforative techniques, taking into account the time from the surgical intervention. MATERIALS AND METHODS: A statistical analysis was conducted on the treatment outcomes of servicemen with traumatic and degenerative damage in the knee joint articular hyaline cartilage. Patients underwent surgical treatment using osteoperforative techniques (abrasive chondroplasty, tunneling, and microfracturing) at the Clinic of Military Traumatology and Orthopedics of the S.M. Kirov Military Medical Academy from 2009 to 2019. The study relied on the data obtained from questioning the patients using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and LKSS questionnaires. RESULTS: The result analyses using the KOOS and LKSS scales revealed significantly higher good results in the observed group in the postoperative period from 1 to 4 years than in the groups from 4 to 8 and more than 8 years (p = 0.004). No significant differences were determined in the treatment outcomes of the groups with resection and different osteoperforative methods. CONCLUSIONS: Treatment methods for hyaline cartilage defects, such as resection and osteoperforative, are technically simple with good treatment outcomes in patients with articular cartilage injuries from 1 to 4 years postoperative. Treatment outcome deterioration was noted in 48 years postoperative, regardless of the treatment method used, which is more significant in patients in 8 years postoperative.

scholarly journals Early Clinical Outcomes Associated with a Novel Osteochondral Allograft Transplantation System in the Knee

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
William J. Long ◽  
Joseph W. Greene ◽  
Fred D. Cushner
Keyword(s):  
Subchondral Bone ◽  
Articular Surface ◽  
Case Series ◽  
Activity Level ◽  
Osteochondral Allograft ◽  
Common Finding ◽  
Cartilage Defects ◽  
Allograft Transplantation ◽  
Pain Symptoms

Background. Osteochondral defects of the knee are a common finding at the time of arthroscopic intervention. Purpose/Hypothesis. To report our outcomes after utilizing a new technique of osteochondral allograft transplantation for focal cartilage defects. Study Design. Case series. Methods. All patients treated with osteochondral allograft transplantation with a Zimmer Chondrofix plug (Zimmer Inc., Warsaw, IN) for focal cartilage defects over a 12-month period were followed up at a minimum of 24 months. Failures were documented and radiographs were evaluated. Results. 61 knees (58 patients) underwent grafting. Three cases were lost to follow-up. In the remaining 58 cases the average age was 40 (range 18–59). At a mean follow-up of 28 months (range 24–36), there were 5 failures requiring further surgery. Mean KOOS scores in the Pain, Symptoms, ADL, Sports, and Quality of Life dimensions were 82, 79, 84, 66, and 58, respectively. Radiographs demonstrated maintenance of the subchondral bone without graft absorption or subsidence. Conclusions. Our observations suggest that osteochondral allograft transplantation leads to a satisfactory activity level and function at early follow-up while avoiding the inherent complexities associated with other cartilage restoration techniques. Longer follow-up is warranted to monitor the subchondral bone, articular surface, and patient outcome measures.

Overlapping Allografts Provide Superior and More Reliable Surface Topography Matching Than Oblong Allografts: A Computer-Simulated Model Study

2021 ◽  
pp. 036354652110030
Author(s):  
Hailey P. Huddleston ◽  
Atsushi Urita ◽  
William M. Cregar ◽  
Theodore M. Wolfson ◽  
Brian J. Cole ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Surface Topography ◽  
Osteochondral Allograft ◽  
Cartilage Defects ◽  
Radius Of Curvature ◽  
Cartilage Surface ◽  
3 Dimensional ◽  
Cloud Models ◽  
And Cartilage ◽  
Osteochondral Allografts

Background: Osteochondral allograft transplantation is 1 treatment option for focal articular cartilage defects of the knee. Large irregular defects, which can be treated using an oblong allograft or multiple overlapping allografts, increase the procedure’s technical complexity and may provide suboptimal cartilage and subchondral surface matching between donor grafts and recipient sites. Purpose: To quantify and compare cartilage and subchondral surface topography mismatch and cartilage step-off for oblong and overlapping allografts using a 3-dimensional simulation model. Study Design: Controlled laboratory study. Methods: Human cadaveric medial femoral hemicondyles (n = 12) underwent computed tomography and were segmented into cartilage and bone components using 3-dimensional reconstruction and modeling software. Segments were then exported into point-cloud models. Modeled defect sizes of 17 × 30 mm were created on each recipient hemicondyle. There were 2 types of donor allografts from each condyle utilized: overlapping and oblong. Grafts were virtually harvested and implanted to optimally align with the defect to provide minimal cartilage surface topography mismatch. Least mean squares distances were used to measure cartilage and subchondral surface topography mismatch and cartilage step-off. Results: Cartilage and subchondral topography mismatch for the overlapping allograft group was 0.27 ± 0.02 mm and 0.80 ± 0.19 mm, respectively. In comparison, the oblong allograft group had significantly increased cartilage (0.62 ± 0.43 mm; P < .001) and subchondral (1.49 ± 1.10 mm; P < .001) mismatch. Cartilage step-off was also found to be significantly increased in the oblong group compared with the overlapping group ( P < .001). In addition, overlapping allografts more reliably provided a significantly higher percentage of clinically acceptable (0.5- and 1-mm thresholds) cartilage surface topography matching (overlapping: 100% for both 0.5 and 1 mm; oblong: 90% for 1 mm and 56% for 0.5 mm; P < .001) and cartilage step-off (overlapping: 100% for both 0.5 and 1 mm; oblong: 86% for 1 mm and 12% for 0.5 mm; P < .001). Conclusion: This computer simulation study demonstrated improved topography matching and decreased cartilage step-off with overlapping osteochondral allografts compared with oblong osteochondral allografts when using grafts from donors that were not matched to the recipient condyle by size or radius of curvature. These findings suggest that overlapping allografts may be superior in treating large, irregular osteochondral defects involving the femoral condyles with regard to technique. Clinical Relevance: This study suggests that overlapping allografts may provide superior articular cartilage surface topography matching compared with oblong allografts and do so in a more reliable fashion. Surgeons may consider overlapping allografts over oblong allografts because of the increased ease of topography matching during placement.

scholarly journals An introduction to Acoustic Emission Analysis (AEA) based medical diagnostic techniques: Screening and Monitoring of cartilage defects in knee joint osteoarthrosis

2020 ◽  
Vol 6 (3) ◽  
pp. 518-521
Author(s):  
Subke Joerg ◽  
Krueger Sabine ◽  
Junker Heinz-Otto ◽  
Schwalbe Hans-Joachim ◽  
Franke Ralf-Peter ◽  
...  
Keyword(s):  
Acoustic Emission ◽  
Load Transfer ◽  
Plane Surface ◽  
Cartilage Damage ◽  
Diagnostic Techniques ◽  
Outer Edge ◽  
Cartilage Defects ◽  
Emission Analysis ◽  
Medical Diagnostic ◽  
Therapeutic Measures

AbstractClinical studies have shown that during standardized movements the Acoustic Emission (AE) from lesions in articular cartilage can be assessed. Specific lesions produce specific acoustic signals, therefore it is possible to evaluate the character of cartilage damage. Consequently it is possible to evaluate the condition of the joint cartilage in order to enhance therapy. Patients performed series of knee bends, first on a plane surface in order to assess the cartilage lesions. Then patients performed knee bends on boards simulating orthopaedic insoles by means of inner and outer edge elevations. Insoles aim at relieving the lesioned areas of cartilage from loads and strain. AEA monitoring reveals the effects of a shift of the zone of load transfer immediately and is an adequate tool for the diagnosis as well as the monitoring of therapeutic measures.

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