Dynamic evaluation of contact pressure and the effects of graft harvest with subsequent lateral release at osteochondral donor sites in the knee.
OBJECTIVE
To dynamically evaluate contact pressure about the periphery of the lateral femoral condyle in intact knees, to qualify the effects of osteochondral donor graft harvest on this contact pressure, and to quantify the effects of lateral release on contact pressure after graft harvest.


METHODS
Cadaveric analysis.


METHODS
Digital electronic pressure-sensing cells were used to measure contact pressure over the periphery of the lateral femoral condyle in 10 fresh-frozen knee specimens. Nonweightbearing resistive extension was simulated as the knees were placed through a functional range of motion. Dynamic pressure readings were evaluated over intact cartilage, around the rims of four 5-mm osteochondral defects, and after lateral release.


RESULTS
The pressure cells were all subjected to contact pressures as the knees were placed through a functional range of motion. Average maximal contact pressure progressed distally as the knees were flexed. The creation of 5-mm osteochondral defects did not lead to a significant increase in rim stress concentration over the surrounding cartilage. Lateral release resulted in small decreases in contact pressure over the osteochondral defects.


CONCLUSIONS
The creation of 5-mm donor defects about the lateral aspect of the lateral femoral condyle does not lead to significant alterations in local contact pressure.


CONCLUSIONS
Our biomechanical findings may have important implications relating to cartilage restoration using osteochondral autografting procedures. Donor-site morbidity may be minimized if donor-site defects are limited to 5 mm and smaller.
Guettler
Joseph H
JH
Sports Medicine Service, William Beaumont Hospital, Royal Oak, Michigan, USA. jguettlermd@wideopenwest.com
Demetropoulos
Constantine K
CK
Yang
King H
KH
Jurist
Kenneth A
KA
D000671:Amputation, Surgical; D001182:Arthroscopy / Q000379:methods; D001696:Biomechanical Phenomena; D002102:Cadaver; D002356:Cartilage / Q000601:surgery; D005269:Femur / Q000601:surgery; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D007866:Leg; D010007:Osteochondritis / Q000601:surgery*; D010329:Patella / Q000601:surgery; D011312:Pressure; D014019:Tissue Donors; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014110:Touch