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Impact Insertion of Osteochondral Grafts: Interference Fit and Central Graft Reduction Affect Biomechanics and Cartilage Damage

机译:骨软骨移植物的冲击插入:过盈配合和中央移植物减少影响生物力学和软骨损伤

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摘要

An osteochondral graft (OCG) is an effective treatment for articular cartilage and osteochondral defects. Impact of an OCG during insertion into the osteochondral recipient site (OCR) can cause chondrocyte death and matrix damage. The aim of the present study was to analyze the effects of graft-host interference fit and a modified OCG geometry on OCG insertion biomechanics and cartilage damage. The effects of interference fit (radius of OCG – radius of OCR), loose (0.00mm), moderate (0.05mm), tight (0.10mm), and of a tight fit with OCG geometry modification (central region of decreased radius) were analyzed for OCG cylinders and OCR blocks from adult bovine knee joints with an instrumented drop tower apparatus. An increasingly tight OCG-OCR interference fit led to increased taps for insertion, peak axial force, graft cartilage axial compression, cumulative and total energy delivery to cartilage, lower time of peak axial force, lesser graft advancement during each tap, higher total crack length in the cartilage surface, and lower chondrocyte viability. The modified OCG, with reduction of diameter in the central area, altered the biomechanical insertion variables and biological consequences to be similar to those of the moderate interference fit scenario. Micro-computed tomography confirmed structural interference between the OCR bone and both the proximal and distal bone segments of the OCGs, with the central regions being slightly separated for the modified OCGs. These results clarify OCG insertion biomechanics and mechanobiology, and introduce a simple modification of OCGs that facilitates insertion with reduced energy while maintaining a structural interference fit.
机译:骨软骨移植(OCG)是治疗关节软骨和骨软骨缺损的有效方法。在插入骨软骨受体位点(OCR)期间,OCG的影响会导致软骨细胞死亡和基质损伤。本研究的目的是分析移植物-宿主过盈配合和改良的OCG几何形状对OCG插入生物力学和软骨损伤的影响。过盈配合(OCG半径– OCR半径),松弛(0.00mm),中等(0.05mm),紧密(0.10mm)以及采用OCG几何形状修改的紧密配合(半径减小的中心区域)的影响为使用仪器式落塔仪分析了成年牛膝关节的OCG气瓶和OCR块。越来越紧密的OCG-OCR过盈配合导致插入丝锥的插入,峰值轴向力,移植物软骨轴向压缩,向软骨的累计能量传递和总能量传递,峰值轴向力的时间缩短,每次丝锥期间移植物前进的时间缩短,总裂纹长度增加在软骨表面,降低软骨细胞活力。修改后的OCG,随着中心区域直径的减小,改变了生物力学插入变量和生物学结果,使其与中等过盈配合情况相似。微型计算机断层扫描证实了OCR骨与OCG的近端和远端骨段之间的结构干扰,而修饰的OCG的中心区域略微分开。这些结果阐明了OCG的插入生物力学和力学生物学,并介绍了一种简单的OCG修饰形式,可简化插入过程并降低能量,同时保持结构过盈配合。

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