Midwest Orthopaedics at Rush University Medical Center, Chicago, Illinois, USA.
University of Texas Medical Branch, Galveston, TX, USA.
Am J Sports Med. 2024 Sep;52(11):2874-2881. doi: 10.1177/03635465241268969. Epub 2024 Aug 26.
Chondrocyte viability is associated with the clinical success of osteochondral allograft (OCA) transplantation.
To investigate the effect of distal femoral OCA plug harvest and recipient site preparation on regional cell viability using traditional handheld saline irrigation versus saline submersion.
Controlled laboratory study.
For each of 13 femoral hemicondyles, 4 cartilage samples were harvested: (1) 5-mm control cartilage, (2) 15-mm OCA donor plug harvested with a powered coring reamer and concurrent handheld saline irrigation ("traditional"), (3) 15-mm OCA donor plug harvested while submerged under normal saline ("submerged"), and (4) 5-mm cartilage from the peripheral rim of a recipient socket created with a 15-mm cannulated counterbore reamer to a total depth of 7 mm with concurrent handheld saline irrigation ("recipient"). The 15 mm-diameter plugs were divided into the central 5 mm and the peripheral 5 mm (2 edges) for comparisons. Samples were stained using calcein and ethidium, and live/dead cell percentages were calculated and compared across groups.
Compared with the submerged group, the traditional group had significantly lower percentages of live cells across the whole plug (71.54% ± 4.82% vs 61.42% ± 4.98%, respectively; = .003), at the center of the plug (72.76% ± 5.87% vs 62.30% ± 6.11%, respectively; = .005), and at the periphery of the plug (70.93% ± 4.51% vs 60.91% ± 4.75%, respectively; = .003). The traditional group had significantly fewer live cells in all plug regions compared with the control group (77.51% ± 9.23%; .0001). There were no significant differences in cell viability between the control and submerged groups (whole: = .590; center: = .713; periphery: = .799). There were no differences between the central and peripheral 5-mm plug regions for the traditional (62.30% ± 6.11% vs 60.91% ± 4.75%, respectively; = .108) and submerged (72.76% ± 5.87% vs 70.93% ± 4.51%, respectively; .061) groups. The recipient group (61.10% ± 5.02%) had significantly lower cell viability compared with the control group ( < .0001) and the periphery of the submerged group ( = .009) but was equivalent to the periphery of the traditional group ( = .990).
There was a significant amount of chondrocyte death induced by OCA donor plug harvesting using a powered coring reamer with traditional handheld saline irrigation, which was mitigated by harvesting the plug while the allograft was submerged under saline.
Mitigating this thermally induced damage by harvesting the OCA plug while the allograft was submerged in saline maintained chondrocyte viability throughout the plug and may help to improve the integration and survival of OCAs.
软骨细胞活力与骨软骨同种异体移植物（OCA）移植的临床成功相关。
使用传统手持盐水冲洗与盐水浸泡的方式，研究股骨远端 OCA 塞子采集和受区准备对局部细胞活力的影响。
对照实验室研究。
对 13 个股骨半关节，每个关节采集 4 个软骨样本：（1）5mm 对照软骨，（2）用动力取芯钻和传统手持盐水冲洗采集的 15mm OCA 供体塞子（“传统”），（3）OCA 供体塞子在生理盐水下浸泡时采集（“浸泡”），以及（4）用 15mm 套钻扩孔器在受区形成的 7mm 总深度的周围边缘采集的 5mm 软骨，同时手持盐水冲洗（“受区”）。15mm 直径的塞子分为中央 5mm 和外周 5mm（2 个边缘）进行比较。样本用钙黄绿素和溴化乙锭染色，计算活/死细胞百分比并在各组之间进行比较。
与浸泡组相比，传统组整个塞子的活细胞百分比显著降低（分别为 71.54%±4.82%和 61.42%±4.98%； =.003），塞子中心（分别为 72.76%±5.87%和 62.30%±6.11%； =.005）和塞子边缘（分别为 70.93%±4.51%和 60.91%±4.75%； =.003）。传统组所有塞子区域的活细胞数量均显著少于对照组（77.51%±9.23%； .0001）。对照组与浸泡组之间细胞活力无显著差异（整体： =.590；中心： =.713；边缘： =.799）。传统组和浸泡组的中央和外周 5mm 塞子区域之间无差异（62.30%±6.11% vs 60.91%±4.75%，分别； =.108）和（72.76%±5.87% vs 70.93%±4.51%，分别； .061）。受区组（61.10%±5.02%）的细胞活力明显低于对照组（ <.0001）和浸泡组的边缘区（ =.009），但与传统组的边缘区相当（ =.990）。
使用动力取芯钻和传统手持盐水冲洗采集 OCA 供体塞子时，会引起大量软骨细胞死亡，而将同种异体移植物浸泡在盐水中采集塞子可减轻这种热诱导损伤。
通过将 OCA 塞子浸泡在盐水中采集，减轻这种热诱导损伤，保持了整个塞子中的软骨细胞活力，这可能有助于提高 OCAs 的整合和存活率。
