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

Kock NB, Smolders JM, van Susante JL, Buma P, van Kampen A, Verdonschot N - Knee Surg Sports Traumatol Arthrosc (2008)

Bottom Line: 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.Following weight bearing motion two out of eight unbottomed mosaicplasties showed subsidence of the plugs according to Tekscan measurements.Unbottomed mosaicplasties may be more susceptible for subsidence below flush level after (unintended) weight bearing motion.

View Article: PubMed Central - PubMed

Affiliation: Orthopaedic Research Laboratory, Department of Orthopaedics, Radboud University Nijmegen Medical Centre, P.O. Box 9101, Nijmegen, The Netherlands.

ABSTRACT
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.

Show MeSH

Related in: MedlinePlus

Graph showing the mosaicplasty contact pressure for three groups; bottomed (blue line), unbottomed (green line) and the whole group (grey line). The mosaicplasty area had almost complete lack of contact pressure after creating a defect (b), in presence of the mosaicplasty the contact surface pressure was regained (c vs. a) and the contact pressure remained stable after non-weight bearing and weight bearing motion (c–e). Standardized deviation values are presented in Table 1
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC2358931&req=5

Fig5: Graph showing the mosaicplasty contact pressure for three groups; bottomed (blue line), unbottomed (green line) and the whole group (grey line). The mosaicplasty area had almost complete lack of contact pressure after creating a defect (b), in presence of the mosaicplasty the contact surface pressure was regained (c vs. a) and the contact pressure remained stable after non-weight bearing and weight bearing motion (c–e). Standardized deviation values are presented in Table 1

Mentions: The pressure pattern of the mosaic contact surface was inverse to the border contact surface pressure (Fig. 5): the mosaicplasty area had almost no contact pressure after creating a defect (B), in the presence of the mosaicplasty the contact surface pressure was regained to some extent (C vs. A) and the contact pressure remained relatively constant after non-weight bearing and weight bearing motions (C–E).Fig. 5


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

Kock NB, Smolders JM, van Susante JL, Buma P, van Kampen A, Verdonschot N - Knee Surg Sports Traumatol Arthrosc (2008)

Graph showing the mosaicplasty contact pressure for three groups; bottomed (blue line), unbottomed (green line) and the whole group (grey line). The mosaicplasty area had almost complete lack of contact pressure after creating a defect (b), in presence of the mosaicplasty the contact surface pressure was regained (c vs. a) and the contact pressure remained stable after non-weight bearing and weight bearing motion (c–e). Standardized deviation values are presented in Table 1
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2358931&req=5

Fig5: Graph showing the mosaicplasty contact pressure for three groups; bottomed (blue line), unbottomed (green line) and the whole group (grey line). The mosaicplasty area had almost complete lack of contact pressure after creating a defect (b), in presence of the mosaicplasty the contact surface pressure was regained (c vs. a) and the contact pressure remained stable after non-weight bearing and weight bearing motion (c–e). Standardized deviation values are presented in Table 1
Mentions: The pressure pattern of the mosaic contact surface was inverse to the border contact surface pressure (Fig. 5): the mosaicplasty area had almost no contact pressure after creating a defect (B), in the presence of the mosaicplasty the contact surface pressure was regained to some extent (C vs. A) and the contact pressure remained relatively constant after non-weight bearing and weight bearing motions (C–E).Fig. 5

Bottom Line: 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.Following weight bearing motion two out of eight unbottomed mosaicplasties showed subsidence of the plugs according to Tekscan measurements.Unbottomed mosaicplasties may be more susceptible for subsidence below flush level after (unintended) weight bearing motion.

View Article: PubMed Central - PubMed

Affiliation: Orthopaedic Research Laboratory, Department of Orthopaedics, Radboud University Nijmegen Medical Centre, P.O. Box 9101, Nijmegen, The Netherlands.

ABSTRACT
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.

Show MeSH
Related in: MedlinePlus