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Journal of Bone and Joint Surgery - British Volume, Vol 87-B, Issue 9, 1285-1291.
doi: 10.1302/0301-620X.87B9.15710  
Copyright © 2005 by British Editorial Society of Bone and Joint Surgery
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Impact loading of articular cartilage during transplantation of osteochondral autograft

R. A. Whiteside, MSc, PhD candidate1; R. P. Jakob, MD, Professor, Orthopaedic Surgeon2; U. P. Wyss, PhD, Professor1; and P. Mainil-Varlet, MD, PhD, Associate Professor3

1 Department of Mechanical and Materials Engineering, McLaughlin Hall, Queen’s University, Kingston K7L 3N6, Canada.
2 Department of Orthopaedic Surgery, Hopital Cantonal Fribourg, Bertigney Strasse, 1700 Fribourg, Switzerland.
3 Institute of Pathology University of Bern, Murtenstrasse 31, 3010 Bern, Switzerland.

Correspondence should be sent to Dr P. Mainil-Varlet; e-mail: pierre.mainil{at}pathology.unibe.ch

Surgical reconstruction of articular surfaces by transplantation of osteochondral autografts has shown considerable promise in the treatment of focal articular lesions. During mosaicplasty, each cylindrical osteochondral graft is centred over the recipient hole and delivered by impacting the articular surface. Impact loading of articular cartilage has been associated with structural damage, loss of the viability of chondrocytes and subsequent degeneration of the articular cartilage. We have examined the relationship between single-impact loading and chondrocyte death for the specific confined-compression boundary conditions of mosaicplasty and the effect of repetitive impact loading which occurs during implantation of the graft on the resulting viability of the chondrocytes.

Fresh bovine and porcine femoral condyles were used in this experiment. The percentage of chondrocyte death was found to vary logarithmically with single-impact energy and was predicted more strongly by the mean force of the impact rather than by the number of impacts required during placement of the graft. The significance of these results in regard to the surgical technique and design features of instruments for osteochondral transplantation is discussed.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General