Effect of Impaction Sequence on Osteochondral Graft Damage: the Role of Repeated and Varying Loads

Overview

Journal Am J Sports Med

Publisher Sage Publications

Specialty Orthopedics

Date 2009 Nov 17

PMID 19915099

Citations 20

Authors

Richard W Kang

Nicole A Friel

James M Williams

Brian J Cole

Markus A Wimmer

Affiliations

Soon will be listed here.

Abstract

Background: Osteochondral autografts and allografts require mechanical force for proper graft placement into the defect site; however, impaction compromises the tissue. This study aimed to determine the effect of impaction force and number of hits to seat the graft on cartilage integrity.

Hypothesis: Under constant impulse conditions, higher impaction load magnitudes are more detrimental to cell viability, matrix integrity, and collagen network organization and will result in proteoglycan loss and nitric oxide release.

Study Design: Controlled laboratory study.

Methods: Osteochondral explants, harvested from fresh bovine trochleae, were exposed to a series of consistent impact loads delivered by a pneumatically driven device. Each plug received the same overall impulse of 7 Ns, reflecting the mean of 23 clinically inserted plugs. Impaction loads of 37.5 N, 75 N, 150 N, and 300 N were matched with 74, 37, 21, and 11 hits, respectively. After impaction, the plugs were harvested, and cartilage was analyzed for cell viability, histology by safranin-O and picrosirius red staining, and release of sulfated glycosaminoglycans (GAGs) and nitric oxide. Data were compared with nonimpacted controls.

Results: Impacted plugs had significantly lower cell viability than nonimpacted plugs. A dose-response relationship in loss of cell viability with respect to load magnitude was seen immediately and after 4 days but lost after 8 days. Histological analysis revealed intact cartilage surface in all samples (loaded or control), with loaded samples showing alterations in birefringence. While the sulfated GAG release was similar across varying impaction loads, release of nitric oxide increased with increasing impaction magnitudes and time.

Conclusion: Impaction loading parameters have a direct effect on the time course of the viability of the cartilage in the graft tissue.

Clinical Relevance: Optimal loading parameters for surgical impaction of osteochondral grafts are those with lower load magnitudes and a greater number of hits to ensure proper fit.

Citing Articles

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Allahabadi S, Haneberg E, Elias T, McMorrow K, Yanke A, Cole B Arthrosc Tech. 2024; 12(12):e2281-e2287.

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Cartilage thickness mismatches in patellar osteochondral allograft transplants affect local cartilage stresses.

Rosario R, Arruda E, Grant J, Coleman R J Orthop Res. 2023; 41(11):2372-2383.

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Compressibility of Osteochondral Autograft Transfer Donor Grafts: A Comparison of Different Donor Regions and How Much Shortening Occurs of Plugs After Impaction.

Massey P, Kushner R, Miller C, Lowery M, Barton R, Solitro G Orthop J Sports Med. 2023; 11(1):23259671221147329.

PMID: 36743726 PMC: 9893359. DOI: 10.1177/23259671221147329.

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Fu L, Yang Z, Gao C, Li H, Yuan Z, Wang F Regen Biomater. 2020; 7(6):527-542.

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Current knowledge of pituitary adenylate cyclase activating polypeptide (PACAP) in articular cartilage.

Lauretta G, Ravalli S, Szychlinska M, Castorina A, Maugeri G, DAmico A Histol Histopathol. 2020; 35(11):1251-1262.

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