title: Subchondral bone reaction associated with chondral defect and attempted cartilage repair in goats.
abstract: Repair of cartilage damage with autologous chondrocyte transplantation (ACT) has become popular in clinical use during the past few years. Although clinical results have mostly been successful, several unanswered questions remain regarding the biological mechanism of the repair process. The aim of this study was to develop a goat model for ACT. The repair was not successful due to the graft delamination, but we characterize the subchondral changes seen after the procedure. A chondral lesion was created in 14 goat knees, operated on 1 month later with ACT, and covered with periosteum or a bioabsorbable poly-L/D-lactide scaffold. After 3 months, only two of the five lesions repaired with ACT showed partly hyaline-like repair tissue, and all lesions (n = 4) with the scaffold failed. Even though the lesions did not extend through the calcified cartilage, the bone volume and collagen organization of bone structure were decreased when assessed by quantitative polarized light microscopy. There was a significant loss of bone matrix and distortion of the trabecular structure of subchondral bone, which extended several millimeters into the bone. The subchondral bone demonstrated strong hyaluronan staining in the bone marrow and cartilaginous areas with signs of endochondral ossification, suggesting structural remodeling of the bone. The goat model used here proved not to be an optimal model for ACT. The changes in subchondral bone may alter the biomechanical properties of the subchondral plate and thus the long-term survival of the repair tissue after ACT.
authors.affiliation: Department of Orthopaedics and Traumatology, Helsinki University Hospital, Helsinki, Finland. anna.vasara@fimnet.fi
authors.forename: A I
authors.initials: AI
authors.lastname: Vasara
authors.forename: M M
authors.initials: MM
authors.lastname: Hyttinen
authors.forename: M J
authors.initials: MJ
authors.lastname: Lammi
authors.forename: P E
authors.initials: PE
authors.lastname: Lammi
authors.forename: T K
authors.initials: TK
authors.lastname: Långsjö
authors.forename: A
authors.initials: A
authors.lastname: Lindahl
authors.forename: L
authors.initials: L
authors.lastname: Peterson
authors.forename: M
authors.initials: M
authors.lastname: Kellomäki
authors.forename: Y T
authors.initials: YT
authors.lastname: Konttinen
authors.forename: H J
authors.initials: HJ
authors.lastname: Helminen
authors.forename: I
authors.initials: I
authors.lastname: Kiviranta
mesh_terms: D000818:Animals; D001182:Arthroscopy / Q000662:veterinary; D001672:Biocompatible Materials / Q000737:chemistry; D001705:Bioprosthesis; D001706:Biopsy; D002208:Caproates / Q000737:chemistry; D002357:Cartilage Diseases / Q000473:pathology / Q000601:surgery*; D002358:Cartilage, Articular / Q000637:transplantation* / Q000648:ultrastructure; D017690:Cell Transplantation; D002478:Cells, Cultured; D019902:Chondrocytes / Q000637:transplantation* / Q000648:ultrastructure; D004195:Disease Models, Animal; D005260:Female; D005269:Femur / Q000473:pathology / Q000637:transplantation; D006041:Goats; D007150:Immunohistochemistry; D019344:Lactic Acid / Q000737:chemistry; D007783:Lactones / Q000737:chemistry; D008297:Male; D008859:Microscopy, Polarization; D013524:Surgical Flaps; D013997:Time Factors; D014182:Transplantation, Autologous
chemical_list: D001672:Biocompatible Materials; D002208:Caproates; D007783:Lactones; D019344:Lactic Acid; C121056:caprolactone