A low morbidity surgical approach to the sheep femoral trochlea

Orth, Patrick; Madry, Henning

doi:10.1186/1471-2474-14-5

Cited by 28 publications

(39 citation statements)

References 57 publications

(62 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Authors: We believe that endochondral ossification is a major mechanism that may be responsible for the upward migration of the subchondral bone plate as well as for the formation of intralesional osteophytes. Similar to P Orth et al The subchondral bone in cartilage repair loading of the articular cartilage defect, based on differences in the range of motion and knee resting positions in various quadruped animal models compared to humans (Orth and Madry, 2013b;Pape and Madry, 2013), could also play a role. However, the definite reasons why some cartilage defects develop subchondral bone alterations while others do not (even in comparable animal models) will have to be further investigated in future studies.…”

Section: Discussion With Reviewersmentioning

confidence: 84%

Alterations of the subchondral bone in osteochondral repair – translational data and clinical evidence

Orth¹,

Cucchiarini²,

Kohn³

et al. 2013

eCM

View full text Add to dashboard Cite

Alterations of the subchondral bone are pathological features associated with spontaneous osteochondral repair and with articular cartilage repair procedures. The aim of this review is to discuss their incidence, extent and relevance, focusing on recent knowledge gained from both translational models and clinical studies of articular cartilage repair. Efforts to unravel the complexity of subchondral bone alterations have identified (1) the upward migration of the subchondral bone plate, (2) the formation of intralesional osteophytes, (3) the appearance of subchondral bone cysts, and (4) the impairment of the osseous microarchitecture as potential problems. Their incidence and extent varies among the different small and large animal models of cartilage repair, operative principles, and over time. When placed in the context of recent clinical investigations, these deteriorations of the subchondral bone likely are an additional, previously underestimated factor that influences the long-term outcome of cartilage repair strategies. Understanding the role of the subchondral bone in both experimental and clinical articular cartilage repair thus holds great promise of being translated into further improved cell-or biomaterial-based techniques to preserve and restore the entire osteochondral unit. Keywords IntroductionA complete restoration of the osteochondral unit is the goal of all articular repair techniques (Brittberg et al., 1994; Johnson, 1986;Pridie, 1959;Steadman et al., 2001). Traditionally, a focus was placed on the cartilaginous repair tissue, but it is now clear that complex structural changes of the subchondral bone are associated with spontaneous osteochondral repair and with the use of cartilage repair procedures . They include (1) the upward migration of the subchondral bone plate, (2) the formation of intralesional osteophytes, (3) the appearance of subchondral bone cysts, and (4) the impairment of the osseous microarchitecture ( Fig. 1).There is accumulating experimental evidence for these subchondral bone alterations in small (Aroen et al., 2006;Chen et al., 2009;Chen et al., 2011a;Heir et al., 2012;Marchand et al., 2011;Marchand et al., 2012;Nam et al., 2004;Qiu et al., 2003) and large preclinical animal models (Dorotka et al., 2005;Frisbie et al., 1999; Hanie et al., 1992;Hoemann et al., 2005;Howard et al., 1994;Ishimaru et al., 1992;Lane et al., 2004;Orth et al., 2012b;Vachon et al., 1986) of cartilage defects. Supporting these findings, such pathological alterations were also reported in up to one third of patients treated with microfracture (Kreuz et al., 2006;Mithoefer et al., 2005; Saris et al., 2009). Moreover, autologous chondrocyte implantation (ACI) for articular cartilage defects previously treated with marrow stimulation techniques has a three-fold higher failure rate than for untreated defects Minas et al., 2009;Vasiliadis et al., 2010). In addition, upward migration of the subchondral bone plate or the development of intralesional osteophytes might also occur spontaneously in...

show abstract

Section: Discussion With Reviewersmentioning

confidence: 84%

Alterations of the subchondral bone in osteochondral repair – translational data and clinical evidence

Orth¹,

Cucchiarini²,

Kohn³

et al. 2013

eCM

View full text Add to dashboard Cite

show abstract

“…Anesthesia was maintained by propofol (6–12 mg/kg BW/h) and inhalation of 1.5% isoflurane (Baxter, Unterschleißheim, Germany). The stifle joints were entered by a minimally invasive surgical approach . On both the weightbearing area of the medial femoral condyle and the lateral facet of the femoral trochlea of each joint, identical defect types were established (Fig.…”

Section: Methodsmentioning

confidence: 99%

“…For example, the quadruped gait with altered biomechanics of the knee joint must be considered. Sheep are easy to handle, although the thickness of the human knee cartilage (2.2 mm) is better reflected by horses (2.0 mm) than by sheep (up to 1.5 mm) . Besides, the ovine stifle joint reflects many key features of the human knee, such as the relative sizes of the articulating bones, the leg axis, and the existence of cruciate ligaments, menisci, asymmetrical collateral ligaments, and a bicondylar distal femur …”

mentioning

confidence: 99%

Improved repair of chondral and osteochondral defects in the ovine trochlea compared with the medial condyle

Orth

Meyer

Goebel

et al. 2013

Journal Orthopaedic Research

Self Cite

View full text Add to dashboard Cite

Associations between topographic location and articular cartilage repair in preclinical animal models are unknown. Based on clinical investigations, we hypothesized that lesions in the ovine femoral condyle repair better than in the trochlea. Full-thickness chondral and osteochondral defects were simultaneously established in the weightbearing area of the medial femoral condyle and the lateral trochlear facet in sheep, with chondral defects subjected to subchondral drilling. After 6 months in vivo, cartilage repair and osteoarthritis development was evaluated by macroscopic, histological, immunohistochemical, and biochemical analyses. Macroscopic and histological articular cartilage repair and type-II collagen immunoreactivity were better in the femoral trochlea, regardless of the defect type. Location-independently, osteochondral defects induced more osteoarthritic degeneration of the adjacent cartilage than drilled chondral lesions. DNA and proteoglycan contents of chondral defects were higher in the condyle, reflecting physiological topographical differences. The results indicate that topographic location dictates the structural patterns and biochemical composition of the repair tissue in sheep. These findings suggest that repair of cartilage defects at different anatomical sites of the ovine stifle joint needs to be assessed independently and that the sheep trochlea exhibits cartilage repair patterns reflective of the human medial femoral condyle. ß

show abstract

“…Sheep meniscus is similar to the human one by length, width, weight, vascularization and collagen structure (Chevrier et al, 2009). The knee joint of the sheep is of the utmost importance for the studies concerning the recovery of articular cartilage defects in large animals and people (Saitz et al, 1997, Orth and Madry, 2013).…”

Section: Introductionmentioning

confidence: 99%

“…CT arthrography is recommended as a convenient imaging diagnostic method (Hontoir et al, 2017;Nelson et al, 2016). The surgery of femoropatellar and femorotibial joints in the sheep is still being developed in order to refine the least invasive method with the least possible post-operative complications (Orth and Madry, 2013).…”

Section: Introductionmentioning

confidence: 99%