Experimental results of donor site filling for autologous osteochondral mosaicplasty.
OBJECTIVE
Autologous osteochondral mosaicplasty has become a treatment option for focal chondral and osteochondral defects in recent years. Excessive postoperative bleeding from the donor site was reported as a possible complication of the procedure. The purpose of this study was to investigate different biodegradable materials for donor site filling, which could prevent excessive postoperative bleeding from these sites but would allow reasonable blood clot formation on the articular surfaces of donor tunnels.


METHODS
Basic science evaluation.


METHODS
In an experimental model, "donor site plugs" made from hydroxylapatite, carbon fiber, polyglyconate-B, compressed collagen, and 2 versions of polycaprolactones were used to fill the bony tunnels created by harvesting. These materials were tested in 100 knees of 50 German Shepherd dogs to determine the quality of the repair tissue formation on the surfaces of the harvesting holes filled by these materials. Arthroscopies of the dogs were performed at several intervals, from 4 weeks to 26 weeks, and macroscopic studies were performed on euthanized animals between 8 weeks and 30 weeks to evaluate donor site filling and coverage. Empty donor tunnels served as controls for the evaluation of the different filling materials.


RESULTS
All tested materials effectively decreased postoperative bleeding. Hydroxylapatite, carbon rods, polyglyconate-B, and melted polycaprolactone materials showed a good integration to the surrounding cancellous bone, but these fillings showed only a limited repair tissue formation, even at 30 weeks postoperatively. Second-look arthroscopy and histologic evaluation of necropsies showed the best fibrocartilage coverage after filling by compressed collagen. Technical details of the filling also had certain importance in the quality of the repair tissue formation.


CONCLUSIONS
According to histologic results, compressed collagen appears to be a good material to fill donor tunnels of osteochondral graft harvest. This material is substituted gradually by bone formation and its articular surface can serve as an appropriate scaffold for fibrocartilage coverage created by the natural intrinsic repair process.
Feczkó
Péter
P
Orthopaedic and Trauma Department Uzsoki Hospital, Budapest, Hungary.
Hangody
László
L
Varga
József
J
Bartha
Lajos
L
Diószegi
Zoltán
Z
Bodó
Gabor
G
Kendik
Zsolt
Z
Módis
László
L
D000818:Animals; D001182:Arthroscopy; D001672:Biocompatible Materials / Q000627:therapeutic use*; D001777:Blood Coagulation; D018786:Bone Substitutes / Q000627:therapeutic use*; D016025:Bone Transplantation; D002244:Carbon; D000077482:Carbon Fiber; D002358:Cartilage, Articular / Q000601:surgery / Q000637:transplantation*; D003094:Collagen; D004285:Dogs; D017886:Durapatite; D005260:Female; D020007:Implants, Experimental; D008297:Male; D008422:Materials Testing; D016348:Osseointegration; D011091:Polyesters; D011108:Polymers; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D020858:Tissue and Organ Harvesting / Q000009:adverse effects*; D014182:Transplantation, Autologous; D014945:Wound Healing
D001672:Biocompatible Materials; D018786:Bone Substitutes; D000077482:Carbon Fiber; D011091:Polyesters; D011108:Polymers; C016240:polycaprolactone; D002244:Carbon; C046409:polyglyconate; D003094:Collagen; D017886:Durapatite