Can Osteochondral Grafting Be Augmented With Microfracture in an Extended-Size Lesion of Articular Cartilage?

• DOI: 10.1177/0363546510363433
• Publication Date: 2010-04-17T02:25:22Z
• Authors: John G. Lane; Robert M. Healey; Albert C. Chen; Robert L. Sah; David Amiel
• Keywords: Subchondral bone; Articular cartilage repair; Biomechanics

Background: Both microfracture and osteochondral autografting procedures have been useful in treating lesions. Hypothesis: Combining can extend the size of lesions that be treated with either technique. Study Design: Descriptive laboratory study. Methods: Eight adult goats underwent autograft transfer a 4.5-mm femoral trochlea plug into an 8-mm full-thickness chondral defect. Microfracture was performed gap region surrounding autograft. The animals were allowed normal activity until end experiment at 6 months. At harvest, knees assessed grossly, then evaluation by histology, histomorphometry, biochemistry, biomechanics. Results: plugs healed well, integration bone preservation cap. between host site articular cartilage transferred had decreased from 3 mm implant to less than 0.1 mm. Histologic analysis demonstrated regions variable repair, layer some sites but incomplete healing others. Histomorphometry filling 75% 85% volume. Biochemical revealed greater 90% type II collagen most sites, areas containing 80% collagen. Biomechanical indentation testing indicated repaired area thickness stiffness, trend increased stiffness bulk graft softness proximal interface site. Conclusion: performance combined procedure resurface large defect appears promising. Clinical Relevance: This technique shows promise for treatment defects single operative autogenous tissue is safe potentially would shorter period rehabilitation, similar transfers microfracture, cost-effective setting.