title: Depth of subchondral perforation influences the outcome of bone marrow stimulation cartilage repair.
abstract: 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.
authors.affiliation: Department of Chemical Engineering and Institute of Biomedical Engineering, Ecole Polytechnique of Montreal, PO 6079 Station Centre-ville, Montreal, Quebec, Canada H3C 3A7.
authors.forename: Hongmei
authors.initials: H
authors.lastname: Chen
authors.forename: Caroline D
authors.initials: CD
authors.lastname: Hoemann
authors.forename: Jun
authors.initials: J
authors.lastname: Sun
authors.forename: Anik
authors.initials: A
authors.lastname: Chevrier
authors.forename: Marc D
authors.initials: MD
authors.lastname: McKee
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Shive
authors.forename: Mark
authors.initials: M
authors.lastname: Hurtig
authors.forename: Michael D
authors.initials: MD
authors.lastname: Buschmann
mesh_terms: D000818:Animals; D054544:Arthroplasty, Subchondral / Q000379:methods*; D001853:Bone Marrow / Q000502:physiology; D002356:Cartilage / Q000254:growth & development; D005260:Female; D011817:Rabbits; D016896:Treatment Outcome; D014945:Wound Healing