Biomechanical and Topographic Considerations for Autologous Osteochondral Grafting in the Knee

This study characterizes the donor and recipient sites involved in osteochondral autograft surgery of the knee with respect to articular cartilage contact pressure, articular surface curvature, and cartilage thickness. Five cadaveric knees were tested in an open chain activity simulation and kinemat...

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Bibliographic Details
Published in:The American journal of sports medicine 2001-03, Vol.29 (2), p.201-206
Main Authors: Ahmad, Christopher S., Cohen, Zohara A., Levine, William N., Ateshian, Gerard A., Van, C. Mow
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biological and medical sciences
Biomechanical Phenomena
Bone Transplantation - methods
Cadaver
Cartilage - pathology
Cartilage - transplantation
Decision Making
Humans
Injuries
Knee
Knee injuries
Knee Joint - pathology
Knee Joint - surgery
Medical sciences
Middle Aged
Models, Biological
Orthopedic surgery
Skin & tissue grafts
Sports injuries
Sports medicine
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Tissue and Organ Harvesting - methods
Tissue Transplantation - methods
Transplantation, Autologous
Weight-Bearing
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Summary:This study characterizes the donor and recipient sites involved in osteochondral autograft surgery of the knee with respect to articular cartilage contact pressure, articular surface curvature, and cartilage thickness. Five cadaveric knees were tested in an open chain activity simulation and kinematic data were obtained at incremental knee flexion angles from 0° to 110°. Surface curvature, cartilage thickness, and contact pressure were determined using a stereophotogrammetry method. In all knees, the medial trochlea, intercondylar notch, and lateral trochlea demonstrated nonloadbearing regions. Donor sites from the distal-medial trochlea were totally nonloadbearing. For the intercondylar notch, lateral trochlea, and proximal-medial trochlea, however, the nonloadbearing areas were small, and typical donor sites in these areas partially encroached into adjacent loadbearing areas. The lateral trochlea (77.1 m −1 ) was more highly curved than the typical recipient sites of the central trochlea (23.3 m −1 ), medial femoral condyle (46.8 m −1 ), and lateral femoral condyles (42.9 m −1 ) ( P < 0.05). Overall, the donor sites had similar cartilage thickness (average, 2.1 mm) when compared with the typical recipient sites (average, 2.5 mm). The lateral trochlea and medial trochlea curvatures were found to better match the recipient sites on the femoral condyles, while the intercondylar notch better matched the recipient sites of the central trochlea. The distal-medial trochlea was found to have the advantage of being nonloadbearing. Preoperative planning using the data presented will assist in more conforming, congruent grafts, thereby maximizing biomechanical function.
ISSN:0363-5465
1552-3365
DOI:10.1177/03635465010290021401