Effect of Osteochondral Graft Insertion Forces on Chondrocyte Viability

Patil, Shantanu; Butcher, William; D’Lima, Darryl D.; Steklov, Nikolai; Bugbee, William D.; Hoenecke, Heinz R.

doi:10.1177/0363546508316765

Cited by 38 publications

(42 citation statements)

References 18 publications

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“…While higher loads appeared to accelerate this process, the final cell viability level could be governed by the applied impulse. A recent study by Patil et al, 30 where osteochondral grafting was performed in 4 fresh-frozen cadaver knees, came to similar conclusions: as long as the load levels were held in typical limits, the decline in cell viability with load after 5 days was not significant.…”

Section: Discussionmentioning

confidence: 70%

Effect of Impaction Sequence on Osteochondral Graft Damage: The Role of Repeated and Varying Loads

et al. 2009

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Background Osteochondral autografts and allografts require mechanical force for proper graft placement into the defect site; however, impaction compromises the tissue. This study aimed to determine the effect of impaction force and number of hits to seat the graft on cartilage integrity. Hypothesis Under constant impulse conditions, higher impaction load magnitudes are more detrimental to cell viability, matrix integrity and collagen network organization and will result in proteoglycan loss and nitric oxide release. Study Design Controlled laboratory study Methods Osteochondral explants, harvested from fresh bovine trochleas, were exposed to a series of consistent impact loads delivered by a pneumatically driven device. Each plug received the same overall impulse of 7 Ns, reflecting the mean of 23 clinically inserted plugs. Impaction loads of 37.5N, 75N, 150N, and 300N were matched with 74, 37, 21, and 11 hits respectively. Following impaction, the plugs were harvested and cartilage was analyzed for cell viability, histology by safranin-o and picosirius red, and release of sulfated glycosaminoglycans and nitric oxide. Data were compared with non-impacted control. Results Impacted plugs had significantly lower cell viability than non-impacted plugs. A dose response relationship in loss of cell viability with respect to load magnitude was seen immediately and after 4 days but lost after 8 days. Histologic analysis revealed intact cartilage surface in all samples (loaded or control), with loaded samples showing alterations in birefringence. While the sulfated GAG release was similar across varying impaction loads, release of nitric oxide increased with increasing impaction magnitudes and time. Conclusions Impaction loading parameters have a direct effect on the time course of the viability of the cartilage in the graft tissue. Clinical Relevance Optimal loading parameters for surgical impaction of osteochondral grafts are those with lower load magnitudes and a greater number of hits to ensure proper fit.

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Section: Discussionmentioning

confidence: 70%

Effect of Impaction Sequence on Osteochondral Graft Damage: The Role of Repeated and Varying Loads

et al. 2009

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“…4,24,38 We found that only 63.3% of chondrocytes remain viable immediately after the procedure and that only 51.6% are viable at 4 days. This finding is consistent with prior in vitro studies on the topic.…”

Section: Cartilage Degradationmentioning

confidence: 79%

Chondrocyte Death and Cartilage Degradation after Autologous Osteochondral Transplantation Surgery in a Rabbit Model

Gulotta

Rudzki²,

Kovacevic

et al. 2009

Am J Sports Med

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“…While chondrocyte viability, especially at the articular surface, is generally inversely related to impact stress, 10,19,30,39,42 the relationship between long-term performance and graft insertion parameters may be dependent of other factors as well. Repetitive trauma causes chondrocyte death, even if each impact is below the threshold for cartilage injury.…”

Section: Discussionmentioning

confidence: 99%

“…Significant impaction forces can sometimes be generated during insertion of osteochondral allografts, and such supra-physiologic loading and other traumatic injury has deleterious effects on chondrocyte viability, especially at the articular surface. 6,10,15,19,30,33,39,42 In addition, during prolonged 4°C storage, chondrocytes, particularly in the superficial zone of cartilage, succumb with increasing storage duration; chondrocyte viability deteriorates substantially in the superficial zone by 14days, 3,26 and overall by 28days. 3,26,31,32,40,43,44,47 While shorter 4°C storage durations (i.e.…”

Section: Introductionmentioning

confidence: 99%

The In Vivo Performance of Osteochondral Allografts in the Goat Is Diminished With Extended Storage and Decreased Cartilage Cellularity

et al. 2012

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Background Currently, osteochondral allografts (OCA) are typically used after 4°C storage for prolonged durations (15-43days), which compromises chondrocyte viability, especially at the articular surface. The long-term in vivo performance of these fresh-stored allografts, in association with variable cellularity, is unknown. Hypothesis/Purpose Determine the effect of 4°C storage duration (14, 28days) versus the best (fresh) and worst (frozen) conditions of chondrocyte viability on structure, composition, and function of cartilage in the goat, and the association of retrieved chondrocyte cellularity with those tissue properties. Study Design Controlled Laboratory Study Methods The effect of allograft storage on in vivo repair outcomes was determined for OCA transplanted into fifteen recipient goats and analyzed at 12months. Repair outcomes were assessed by examining cartilage structure (gross, histopathology), composition (cellularity by depth, matrix fixed charge), and biomechanical function (stiffness). Relationships between cellularity and structural scores, matrix fixed charge, and stiffness were assessed by linear regression. Results Repair outcomes in 4°C-stored OCA were inferior to fresh OCA, and were accompanied by diminished cellularity at the surface, matrix fixed charge, and histopathological structure. Overall, cellularity by depth and matrix fixed charge in cartilage of fresh OCA were similar to non-operated controls. However, cellularity at the articular surface and matrix fixed charge in 4°C-stored OCA were lower than fresh, by ~55% (95%CI, 32-76%) and ~20% (95%CI, 9-30%), respectively. In frozen OCA, cellularity and matrix fixed charge were lower than 4°C-stored OCA, by ~93% (95%CI, 88-99%) and ~22% (95%CI: 10-35%), respectively. Cellularity correlated negatively with cartilage health indices, including structural scores, and positively with matrix fixed charge and stiffness. Conclusion Reduced cellularity at the articular surface, resulting from 4°C storage, was associated with variable long-term outcomes, versus consistently good repair by fresh allografts. Cellularity at the articular surface was an important index of biological performance. Clinical Relevance Normal chondrocyte density in vivo, especially in the superficial region of cartilage, is important for maintaining long-term cartilage function and matrix content. In human cartilage, containing cells at ~3-5× lower density than goat, repair outcomes may be related to absolute minimum number of cells rather than density.

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Effect of Osteochondral Graft Insertion Forces on Chondrocyte Viability

Abstract: Any theoretical benefits of cancellous bone compaction that may occur in grafts that are recessed or are longer than the recipient holes must be balanced against the potential reduction in chondrocyte viability.

Cited by 38 publications

References 18 publications

Effect of Impaction Sequence on Osteochondral Graft Damage: The Role of Repeated and Varying Loads

Effect of Impaction Sequence on Osteochondral Graft Damage: The Role of Repeated and Varying Loads

Chondrocyte Death and Cartilage Degradation after Autologous Osteochondral Transplantation Surgery in a Rabbit Model

The In Vivo Performance of Osteochondral Allografts in the Goat Is Diminished With Extended Storage and Decreased Cartilage Cellularity

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