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Depth of subchondral perforation influences the outcome of bone marrow stimulation cartilage repair
Author(s) -
Chen Hongmei,
Hoemann Caroline D.,
Sun Jun,
Chevrier Anik,
McKee Marc D.,
Shive Matthew S.,
Hurtig Mark,
Buschmann Michael D.
Publication year - 2011
Publication title -
journal of orthopaedic research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.041
H-Index - 155
eISSN - 1554-527X
pISSN - 0736-0266
DOI - 10.1002/jor.21386
Subject(s) - cartilage , medicine , hyaline cartilage , perforation , bone marrow , subchondral bone , matrix (chemical analysis) , bone healing , stimulation , surgery , biomedical engineering , anatomy , pathology , articular cartilage , osteoarthritis , chemistry , materials science , alternative medicine , punching , chromatography , metallurgy
Subchondral drilling and microfracture are bone marrow stimulation techniques commonly used for the treatment of cartilage defects. Few studies to date have examined the technical variants which may influence the success of the cartilage repair procedures. This study compared the effect of hole depth (6 mm vs. 2 mm) and hole type (drill vs. microfracture) on chondral defect repair using a mature rabbit model. Results from quantitative histomorphometry and histological scoring showed that deeper versus shallower drilling elicited a greater fill of the cartilage defect with a more hyaline character in the repair matrix indicated by significant improvement ( p = 0.021) in the aggregate measure of increased cartilage defect fill, increased glycosaminoglycan and type II collagen content and reduced type I collagen content of total soft repair tissue. Compared to microfracture at the same 2 mm depth, drilling to 2 mm produced a similar quantity and quality of cartilage repair ( p = 0.120) according to the aggregate indicator described above. We conclude that the depth of bone marrow stimulation can exert important influences on cartilage repair outcomes. © 2011 Orthopaedic Research Society Published by Wiley Periodicals, Inc. J Orthop Res 29: 1178–1184, 2011