Download PDF
Vet Comp Orthop Traumatol 1993; 06(02): 80-84
DOI: 10.1055/s-0038-1633024
Original Research
Schattauer GmbH

A Comparison of Four Different Methods of Fixation of Osteochondral Fragments

B. J. Van Vechten
1   Veterinary Medical Teaching Hospital, University of California, Davis, California, USA
,
P. B. Vasseur
2   Departments of Surgery, University of California, Davis, California, USA
,
J.J. Rodrigo
4   Department of Orthopedics, School of Medicine, University of California, Davis, California, USA
,
W. Johnson
1   Veterinary Medical Teaching Hospital, University of California, Davis, California, USA
,
P. H. Kass
3   Epidemiology and Preventive Medicine, School of Veterinary Medicine, University of California, Davis, California, USA
› Author Affiliations
Further Information

Publication History

Received for publication 25 September 1992

Publication Date:
09 February 2018 (online)

    Permissions and Reprints

Summary

Fixation methods for osteochondral shell grafts were studied using replace-ment of a femoral trochlear autograft in rabbits as the model. Twenty skeletally mature rabbits were divided into four groups with five rabbits in each. The articular cartilage of the femoral trochlea, including 2.0 mm of subchondral bone, was removed using a sagittal bone saw. The grafts were immediately reattached using either small Kirschner pins (K-pins), polydioxanone pins (PDP), polydioxanone suture (PDS), or polymethylmethacrylate (PMMA) cement. Six months postoperatively the rabbits were killed and the graft sites compared to the contralateral control using radiography, gross examination, Safranin-O and H & E staining, and sulphate-35 radioactive uptake. Mild degenerative joint changes were evident radio-graphically in all of the operated joints. Articular surface defects at the graft sites were common and included small craters and erosions; a few had larger areas devoid of cartilage. Defects associated with the pin entrance sites were common in the K-pin and PD P groups. The PDS group had the least number of animals with articular surface defects. Safranin-O staining was complete in the PDS group, partial or complete in the K-pin and PD P groups, and partial in all of the joints in the PMM A group. H & E preparations of the cartilage sections were graded from 1 (normal cartilage) to 5 (multiple fissures, severe degradation). The PDS group had a mean (SD) score of 1.8 (0.8), the PD P group 2.4 (1.1), the K-pin group 2.5 (1.3), and the PMM A group 4.6 (0.6). The scores for the PMM A group were significantly greater then the scores for the other groups (p <0.05). The mean (SD) for radioactive counts per minute/mg tissue in treated graft sites as a percent of control was PDS: 130 (83); PDP : 115 (14); K-pins: 92 (42); PMMA : 91 (29). The relative percentages for radioactive uptake were not significantly different (P >0.05). Graft fixation using PDS, PDP, or K-pins was technically easy to perform and the results were generally satisfactory. Fixation using PMM A was technically demanding and histological evidence of moderate to severe cartilage degradation was present in all treated joints.

Femoral trochlear autografts in rabbits were used to study fixation methods for osteochondral graft fragments. Six months after the operations the graft sites were evaluated using radiographs, gross examination, Safranin-O and H & E staining, and sulphate-35 radioactive uptake. Grafts stabilized using polydioxanone suture had the least number of articular surface defects and the most complete Safranin-O staining.

Keywords

Osteochondral graft - fixation - rabbit - cartilage defects
 

  • References

  • 1 Kusnick C, Hayward I, Sartoris DJ. et al. Radiographic evaluation of joints resur-faced with osteochondral shell allografts. Am J Roentgenology 1987; 149: 743-8.
    CrossrefPubMedGoogle Scholar
  • 2 Kwan MK, Wayne JS, Woo SL-Y. et al. Histological and biomcchanical assessment of articular cartilage from stored osteochondral shell allografts. J Orthop Res 1989; 7: 637-44.
    CrossrefPubMedGoogle Scholar
  • 3 Czitrom AA, Keating S, Gross AE. The viability of articular cartilage in fresh osteochondral allografts after clinical transplantation. J Bone Joint Surg 1990; 72A: 574-81.
    PubMedGoogle Scholar
  • 4 Meyers MH, Akcson W, Convery FR. Resurfacing of the knee with fresh osteochondral allograft. J Bone Joint Surg 1989; 71A: 704-13.
    PubMedGoogle Scholar
  • 5 Oakeshott RD, Farinc I, Pritzker KPH. et al. A clinical and histologic analysis of failed fresh osteochondral allografts. Clin Orthop 1988; 233: 283-94.
    PubMedGoogle Scholar
  • 6 Stevenson S. The immune response to osteochondral allografts in dogs. J Bone Joint Surg 1987; 69A: 573-82.
    PubMedGoogle Scholar
  • 7 Miller BJ, Bakirtzian B, Hadjipavlou A, Lander P. Allografts in orthopedic surgery: a case report and literature review. Can J Surg 1987; 30: 35-8.
    PubMedGoogle Scholar
  • 8 Rodrigo J, Thompson E, Travis C. Deep-freezing versus 4 degree preservation of avascular osteocartilagenous shell allografts in rats. Clin Orthop 1987; 218: 268-75.
    PubMedGoogle Scholar
  • 9 Schachar N, Nagao M, Matsuyama T. et al. Cryopreserved articular chondrocytes grow in culture, maintain cartilage phenotypc, and synthesize matrix components. J Orthop Res 1989; 7: 344-51.
    CrossrefPubMedGoogle Scholar
  • 10 Tomford W, Mankin H, Friedlaender GE. et al. Methods of banking bone and cartilage for allograft transplantation. Orthop Clin North Am 1987; 18: 241-7.
    PubMedGoogle Scholar
  • 11 Daniel WW. Applied nonparametric statistics. Houghton Mifflin Company; Boston: 1978
    Google Scholar
  • 12 Holm SA. A simple sequentially rejective multiple test procedure. Scand J Statistics 1979; 6: 65-70.
    PubMedGoogle Scholar
  • 13 Boone EG, Hohn RB, Weisbrode SR. Trochlear recession wedge technique for patellar luxation: an experimental study. J Am Anim Hosp Assoc 1983; 19: 735-42.
    PubMedGoogle Scholar