A cadaveric analysis of contact stress restoration after osteochondral transplantation of a cylindrical cartilage defect

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Vol. 16; no. 5; pp. 461 - 468
• Main Authors: Kock, Niels B., Smolders, José M. H., van Susante, Job L. C., Buma, Pieter, van Kampen, Albert, Verdonschot, Nico
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.05.2008; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Arthritis; Biomechanical Phenomena; Biomechanics; Cadaver; Cadavers; Cartilage; Cartilage - transplantation; Defects; Humans; Knee; Knee - surgery; Medicine; Medicine & Public Health; Orthopedic Procedures - methods; Orthopedics; Osteoarthritis; Sensors; Stress, Mechanical; Transplants & implants; Weight-Bearing; Netherlands; Biomechanics; Cartilage; Knee Joint/Surgery; Articular/pathology; Humans; Surface Properties; Autologous; Transplantation; Pressure; Weight-bearing
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-008-0494-1

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.