Lane John G, Massie Jennifer B, Ball Scott T, Amiel Michael E, Chen Albert C, Bae Won C, Sah Robert L, Amiel David
Coast Sports Med Group, San Diego, California, USA.
Am J Sports Med. 2004 Sep;32(6):1440-50. doi: 10.1177/0363546504263945. Epub 2004 Jul 20.
Osteochondral transfer procedures are increasingly used to resurface full-thickness articular cartilage defects. There has not been long-term assessment/description of autogenous donor and recipient sites.
The healing process occurs at the donor/host cartilage and bone interfaces.
Histologic, biochemical, and biomechanical changes were assessed 6 months after an osteochondral transfer in a goat model.
Eight adult goats were studied. In the 6 osteochondral transfer goats, 2 autogenous plugs were transferred from the femoral trochlea to defects in the weightbearing portion of the medial femoral condyle. The goats were allowed free range for 6 months. Randomly assigned plugs were assessed.
Knees of the sacrificed animals had preservation of the joint space with mild chondromalacic changes in both transfer and contralateral control groups. Histologically, no evidence of cartilage (host/donor) healing was seen. Subchondral bone of the plug was contiguous with the surrounding recipient bone. Cellular viability in the autogenous osteochondral plug was seen, and 35SO4 uptake of the articular cartilage was not statistically different from the contralateral control condyle. The indentation stiffness of the transfer plug (mosaicplasty) and the contralateral donor site were similar--much stiffer than normal cartilage including surrounding condylar cartilage. Large structural stiffness of transferred cores and donor sites appeared to be related to their thinner cartilage layer.
At 6-month follow-up, a cleft between host and transferred articular regions remained, with no integration between the two.
Autogenous transplantation of osteochondral plugs is possible with integration of subchondral bone and preservation of chondral viability.
骨软骨移植手术越来越多地用于修复全层关节软骨缺损。目前尚未对自体供体和受体部位进行长期评估/描述。
愈合过程发生在供体/宿主软骨和骨界面。
在山羊模型中进行骨软骨移植6个月后，评估组织学、生化和生物力学变化。
对8只成年山羊进行研究。在6只接受骨软骨移植的山羊中，将2个自体移植物从股骨滑车转移至内侧股骨髁负重部分的缺损处。让山羊自由活动6个月。对随机分配的移植物进行评估。
处死动物的膝关节关节间隙保留，移植组和对侧对照组均有轻度软骨软化改变。组织学上，未见软骨（宿主/供体）愈合迹象。移植物的软骨下骨与周围受体骨相连。可见自体骨软骨移植物中的细胞活力，关节软骨的35SO4摄取与对侧对照髁无统计学差异。移植移植物（镶嵌成形术）和对侧供体部位的压痕硬度相似——比包括周围髁软骨在内的正常软骨硬得多。移植核心和供体部位的大结构硬度似乎与其较薄的软骨层有关。
在6个月的随访中，宿主和移植关节区域之间仍存在裂隙，两者未融合。
自体骨软骨移植物移植是可行的，软骨下骨可融合且软骨活力得以保留。
