Transplantation of free tibial periosteal grafts for the repair of articular cartilage defect: An experimental study

Abstract

Background:Articular chondrocytes have got a long lifespan but rarely divides after maturity. Thus, an articular cartilage has a limited capacity for repair. Periosteal grafts have chondrogenic potential and have been used to repair defects in the articular cartilage. The purpose of the present study is to investigate the differentiation of free periosteal grafts in the patellofemoral joint where the cambium layer faces the subchondral bone and to investigate the applicability of periosteal grafts in the reconstruction of articular surfaces.Materials and Methods:The study was carried out over a period of 1 year on 25 adult, male Indian rabbits after obtaining permission from the institutional animal ethical committee. A full-thickness osteochondral defect was created by shaving off the whole articular cartilage of the patella of the left knee. The defect thus created was grafted with free periosteal graft. The patella of the right knee was taken as a control where no grafting was done after shaving off the articular cartilage. The first animal was used to study the normal histology of the patellar articular cartilage and periosteum obtained from the medial surface of tibial condyle. Rest 24 animals were subjected to patellectomy, 4 each at serial intervals of 2, 4, 8, 16, 32 and 48 weeks and the patellar articular surfaces were examined macroscopically and histologically.Results:The grafts got adherent to the underlying patellar articular surface at the end of 4 weeks. Microscopically, graft incorporation could be appreciated at 4 weeks. Mesenchymal cells of the cambium layer were seen differentiating into chondrocytes by the end of 4 weeks in four grafts (100%) and they were arranged in a haphazard manner. Till the end of 8 weeks, the cellular arrangement was mostly wooly. At 16 weeks, one graft (25%) had wooly arrangement of chondrocytes and three grafts (75%) had columnar formation of cells. Same percentage was maintained at 32 weeks. Four grafts (100%) at 48 weeks showed columnar orientation. The control side showed no changes over the shaved off articular surface in all the rabbits. One rabbit at 4 weeks had a dislocation of the patella on the control side. None of the rabbits developed any infection or wound dehiscence.Conclusion:Autologous periosteal graft transplantation can be a promising substitute for articular cartilaginous defects.

Periosteum: Functional Anatomy and Clinical Application

“…Several studies demonstrated the importance of periosteal autologous transplantation in fracture healing and bone formation (52,55,56). Periosteal graft is usually placed on bare bone, and it can be transplanted either with attached blood vessels (vascularised) or without blood vessels (non-vascularised) (57).…”

Surgical methods of focal hyaline cartilage defect management in large joints (literature review)

“…O'Driscoll впервые в эксперимен-те на животных показал, что надкостница может про-дуцировать хондроциты и, тем самым, служить источ-ником восстановления дефектов гиалинового хряща. В дальнейшем подобные результаты нашли подтвержде-ние у других авторов [27]. Сегодня нет единого мнения относительно положения и ориентации надкостницы в ложе дефекта.…”

Indian Journal of Orthopaedics: Exploring a new horizon

“…For the year 2009, the winner of SN Baxi award was Dr. K.H. Sancheti3 from Pune and IOA Best Publication award in Research Category was won by Dr. Ravijot Singh 4…”

“…Sancheti 3 from Pune and IOA Best Publication award in Research Category was won by Dr. Ravijot Singh. 4 We intend to start online case report version of Indian Journal of Orthopaedics and if the number of case reports are good then we can even print them as supplement. We are likely to get our first impact factor in 2011.…”