Topographic Analysis of the Capitellum and Distal Femoral Condyle: Finding the Best Match for Treating Osteochondral Defects of the Humeral Capitellum

Shin, Jason J.; Haro, Marc S.; Yanke, Adam B.; Mascarenhas, Randhir; Romeo, Anthony A.; Cole, Brian J.; Inoue, Nozomu; Verma, Nikhil N.

doi:10.1016/j.arthro.2014.11.039

Cited by 18 publications

(21 citation statements)

References 29 publications

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“…Each point-plane distance between the articular cartilage surfaces of the graft and defect models was calculated so that the graft model was optimally positioned to minimize surface mismatch with the defect model. 14,19,22 The shortest distance from the point in question on the defect model to the corresponding point in space on the graft model was measured as the mismatch between the 2 models. A perfect congruent match equaled a mismatch of 0 mm for given data points on the simulated articular surface.…”

Section: Methodsmentioning

confidence: 99%

Overlapping Allografts Provide Superior and More Reliable Surface Topography Matching Than Oblong Allografts: A Computer-Simulated Model Study

et al. 2021

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Background: Osteochondral allograft transplantation is 1 treatment option for focal articular cartilage defects of the knee. Large irregular defects, which can be treated using an oblong allograft or multiple overlapping allografts, increase the procedure’s technical complexity and may provide suboptimal cartilage and subchondral surface matching between donor grafts and recipient sites. Purpose: To quantify and compare cartilage and subchondral surface topography mismatch and cartilage step-off for oblong and overlapping allografts using a 3-dimensional simulation model. Study Design: Controlled laboratory study. Methods: Human cadaveric medial femoral hemicondyles (n = 12) underwent computed tomography and were segmented into cartilage and bone components using 3-dimensional reconstruction and modeling software. Segments were then exported into point-cloud models. Modeled defect sizes of 17 × 30 mm were created on each recipient hemicondyle. There were 2 types of donor allografts from each condyle utilized: overlapping and oblong. Grafts were virtually harvested and implanted to optimally align with the defect to provide minimal cartilage surface topography mismatch. Least mean squares distances were used to measure cartilage and subchondral surface topography mismatch and cartilage step-off. Results: Cartilage and subchondral topography mismatch for the overlapping allograft group was 0.27 ± 0.02 mm and 0.80 ± 0.19 mm, respectively. In comparison, the oblong allograft group had significantly increased cartilage (0.62 ± 0.43 mm; P < .001) and subchondral (1.49 ± 1.10 mm; P < .001) mismatch. Cartilage step-off was also found to be significantly increased in the oblong group compared with the overlapping group ( P < .001). In addition, overlapping allografts more reliably provided a significantly higher percentage of clinically acceptable (0.5- and 1-mm thresholds) cartilage surface topography matching (overlapping: 100% for both 0.5 and 1 mm; oblong: 90% for 1 mm and 56% for 0.5 mm; P < .001) and cartilage step-off (overlapping: 100% for both 0.5 and 1 mm; oblong: 86% for 1 mm and 12% for 0.5 mm; P < .001). Conclusion: This computer simulation study demonstrated improved topography matching and decreased cartilage step-off with overlapping osteochondral allografts compared with oblong osteochondral allografts when using grafts from donors that were not matched to the recipient condyle by size or radius of curvature. These findings suggest that overlapping allografts may be superior in treating large, irregular osteochondral defects involving the femoral condyles with regard to technique. Clinical Relevance: This study suggests that overlapping allografts may provide superior articular cartilage surface topography matching compared with oblong allografts and do so in a more reliable fashion. Surgeons may consider overlapping allografts over oblong allografts because of the increased ease of topography matching during placement.

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Section: Methodsmentioning

confidence: 99%

Overlapping Allografts Provide Superior and More Reliable Surface Topography Matching Than Oblong Allografts: A Computer-Simulated Model Study

et al. 2021

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“…8 Two studies have investigated knee-toelbow matching in a quantitative way as opposed to our qualitative assessment. 6,7 Vezeridis and Bae 7 reported <1 mm of articular incongruity when a 10-mm graft was harvested from the anterior nonweightbearing part of the femoral condyle. Shin et al 6 found a smaller difference (<0.6 mm) in articular surface match between the capitellum and the femoral condyle.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] Several factors need to be taken into account for a proper match between the donor graft and the recipient site, including the curvature of the articular surface and cartilage thickness. [5][6][7][8] Ideally, the curvature of a donor graft is similar to that of the recipient site to maintain the biomechanical properties of the elbow joint. [9][10][11] Cartilage thickness should also be taken into account because plugs heal to the subchondral and deeper bone and not along the cartilage surface.…”

Section: See Commentary On Page 3033mentioning

confidence: 99%

“…The following parameters were included based on the current literature and the experience of 2 senior authors (D.E. and D.S-H.): cartilage thickness (in tenths of millimeters), 5,7,20,21 shape of the articular surface (convex or concave), 6,7 and 13 parameters of the International Cartilage Repair Society (ICRS) II (Table 1). 22,23 The ICRS II is a commonly used and reliable histologic scoring system for cartilage repair.…”

Section: Histologic Parametersmentioning

confidence: 99%

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Histologic Analysis of 2 Alternative Donor Sites of the Ipsilateral Elbow in the Treatment of Capitellar Osteochondritis Dissecans

Bexkens

Bekerom

Eygendaal

et al. 2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…Previous studies mostly focused on topographic anatomy for osteochondral autografting. 12,13,[15][16][17]20 However, there are few studies that evaluate topographic matching of the distal femoral condyle to find the optimal donor site for OCA transplantation. [18][19][20] Typical clinical practice involves obtaining OCAs with the same side, condyle, and size, which can result in limited graft availability and increased patient wait time to find a matching graft.…”

Section: Discussionmentioning

confidence: 99%

Topographic Analysis of the Distal Femoral Condyle Articular Cartilage Surface: Adequacy of the Graft from Opposite Condyles of the Same or Different Size for the Osteochondral Allograft Transplantation

et al. 2018

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Objective To analyze the topography of the opposite condyle to treat focal femoral condyle articular defects with an osteochondral allograft (OCA). Design Three groups were created: Group 1, same condyle with same width; Group 2, opposite condyle with same width; Group 3, opposite condyle with different width. Computed tomography (CT) of 22 cadaveric femoral hemi-condyles was used to create 3-dimensional CT models that were exported into point-cloud models. Three zones of the donor condyle (anterior, middle, and posterior) were quantified. Four defect sizes were created (15, 18, 23, 25 mm) at the weight-bearing region. The defect was moved throughout each donor condyle zone and the least distance was calculated, defined as the shortest distance between the defect and the donor condyle. Results The mean least distance increased with larger defect size in all groups, yet there was a less than 0.2 mm difference in the least distance among defect sizes. The 15, 18, and 23 mm defect models in Group 1 exhibited greater least distances at the anterior than middle and posterior zones. The 15 mm defect model exhibited greater least distance at the anterior zone than posterior zone in Group 3. However, there was a less than 0.05 mm difference in the mean least distance between zones. There was no significant difference in the least distance between groups. Conclusion OCAs from opposite condyles yield similar topographic matching to OCAs from the same condyles, suggesting that opposite condyles can be utilized. Clinical correlation and outcomes are necessary.

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Topographic Analysis of the Capitellum and Distal Femoral Condyle: Finding the Best Match for Treating Osteochondral Defects of the Humeral Capitellum

Cited by 18 publications

References 29 publications

Overlapping Allografts Provide Superior and More Reliable Surface Topography Matching Than Oblong Allografts: A Computer-Simulated Model Study

Overlapping Allografts Provide Superior and More Reliable Surface Topography Matching Than Oblong Allografts: A Computer-Simulated Model Study

Histologic Analysis of 2 Alternative Donor Sites of the Ipsilateral Elbow in the Treatment of Capitellar Osteochondritis Dissecans

Topographic Analysis of the Distal Femoral Condyle Articular Cartilage Surface: Adequacy of the Graft from Opposite Condyles of the Same or Different Size for the Osteochondral Allograft Transplantation

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