Fig 2 - available from: Journal of Orthopaedic Surgery and Research
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Osteochondral defect sites at the talus (schematic illustration). Single asterisk, covered talus; double asterisk, uncovered talus
Source publication
Background
Although differences in the results of the bone marrow stimulation technique between the knee and ankle have been reported, a detailed mechanism for those differences has not been clarified. The purpose of this study was to examine whether morphological differences between the knee and ankle joint affect the results of drilling as treatm...
Context in source publication
Context 1
... tip of the MFC, a partially weight-bearing area. The weight-bearing area in the flexed knee of rabbits is at the inferoposterior aspect [18]. The osteochondral defect of the patellar groove was created at the center of the groove and under the patella in a flexed position (Fig. 1). Two types of osteo- chondral defects were created at the talus (Fig. 2). The osteochondral defect at the center of the left talus was defined as a covered area (covered talus) that contacts the articular surface of the plafond of the tibia during all motion of the ankle joint. The osteochondral defect at Fig. 1 Osteochondral defect sites at the knee. PG patellar groove, MFC medial femoral condyle the ...
Similar publications
Background
Hyaline cartilage calcification (CC) is associated with osteoarthritis (OA) in hip and knee joints. The first metatarsophalangeal joint (1stMTPJ) is frequently affected by OA, but it is unclear if CC occurs in the 1stMTPJ. The aim of the present study was to analyze the prevalence of CC of the 1stMTPJ in the general population by high-re...
Citations
... Using micro-CT analysis, the authors analyzed the microfracture channels for sclerosis and marrow access and found that bone marrow stimulation techniques using instruments with larger diameters led to increased trabecular compaction and sclerosis adjacent to the area of bone marrow stimulation; however, their study was limited to talar cartilage, which has different intrinsic properties than knee articular cartilage. 16,18,19 Their results were similar to those described in our study; however, our study was able to include newer technology in the form of the microdrill, which had significantly decreased compression adjacent to the defect than the larger-diameter bone marrow stimulation instruments. 16 The status of the subchondral bone architecture has been shown to play a significant role in the long-term health of the chondral surface, and as more recent evidence has shown, may have an impact on future cartilage restoration procedures. ...
Purpose
The purpose of this study was to compare bone marrow stimulation using micro-computed tomography (micro-CT) analysis of an abrasion arthroplasty technique, drilling k-wire technique, traditional microfacture awl, or a microdrill instrument for subchondral bone defects.
Methods
Eleven cadaveric distal femoral specimens were obtained and divided into 3 common areas of osteochondral defect: trochlea and weightbearing portions of the medial and lateral femoral condyles. Each area of interest was then denuded of cartilage using a PoweRasp and divided into quadrants. Each quadrant was assigned either a 1.6 mm Kirschner wire (k-wire), 1.25 mm microfracture awl, 1.5 mm fluted microdrill, PowerPick, or a curette (abrasion arthroplasty) to create 4 channels into the subchondral bone sing the same instrument. Subchondral bone and adjacent tissue areas were then evaluated using micro-CT to analyze adjacent bone destruction and extension into the bone marrow.
Results
Overall, there was a significantly decreased area of bone destruction or compression using the microdrill (0.030 mm) as compared to the microfracture awl (0.072 mm) and k-wire (0.062 mm) (P < .05). Within the trochlea and the medial femoral condyle, there was significantly decreased bony compression with the microdrill as compared to the awl and k-wire (P < .05); however, when stratified, this was not significant among the lateral femoral condylar samples (P = .08).
Conclusion
Bone marrow stimulation causes bony compression that may negatively impact subchondral bone and trabecular alignment. It is important to understand which tools used for bone marrow stimulation cause the least amount of damage to the subchondral bone.
Clinical Relevance
This study demonstrates the decreased subchondral bony defects seen with the microdrill versus the traditional microfracture awl indicating that when performing bone marrow stimulation, the microdrill may be a less harmful tool to the subchondral bone.
... The articular cartilage is primarily composed of chondrocytes and extracellular matrix (ECM) that mainly contains water, collagen type II, and proteoglycans such as aggrecan [3][4][5]. When articular cartilage suffers focal or degenerative lesions caused by trauma or disorders, it has a limited capacity for self-healing because of its avascularity and low cellularity and ultimately could evolve into osteoarthritis (OA) that in turn could result in the degradation of articular Ivyspring International Publisher hyaline cartilage and subchondral bone structural remodeling [6][7][8][9][10][11][12]. Thus, it is extremely significant to repair osteochondral defects and acquire new cartilage and bone tissues. ...
When osteochondral tissues suffer from focal or degenerative lesions caused by trauma or disorders, it is a tough challenge to regenerate them because of the limited self-healing capacity of articular cartilage. In this study, a series of Mo-doped bioactive glass ceramic (Mo-BGC) scaffolds were prepared and then systematically characterized. The released MoO4²⁻ ions from 7.5Mo-BGC scaffolds played a vital role in regenerating articular cartilage and subchondral bone synchronously.
Methods: The Mo-BGC scaffolds were fabricated through employing both a sol-gel method and 3D printing technology. SEM, EDS, HRTEM, XRD, ICPAES and mechanical strength tests were respectively applied to analyze the physicochemical properties of Mo-BGC scaffolds. The proliferation and differentiation of rabbit chondrocytes (RCs) and human bone mesenchymal stem cells (HBMSCs) cultured with dilute solutions of 7.5Mo-BGC powder extract were investigated in vitro. The co-culture model was established to explore the possible mechanism of stimulatory effects of MoO4²⁻ ions on the RCs and HBMSCs. The efficacy of regenerating articular cartilage and subchondral bone using 7.5Mo-BGC scaffolds was evaluated in vivo.
Results: The incorporation of Mo into BGC scaffolds effectively enhanced the compressive strength of scaffolds owing to the improved surface densification. The MoO4²⁻ ions released from the 7.5Mo-BGC powders remarkably promoted the proliferation and differentiation of both RCs and HBMSCs. The MoO4²⁻ ions in the co-culture system significantly stimulated the chondrogenic differentiation of RCs and meanwhile induced the chondrogenesis of HBMSCs. The chondrogenesis stimulated by MoO4²⁻ ions happened through two pathways: 1) MoO4²⁻ ions elicited anabolic responses through activating the HIF-1α signaling pathway; 2) MoO4²⁻ ions inhibited catabolic responses and protected cartilage matrix from degradation. The in vivo study showed that 7.5Mo-BGC scaffolds were able to significantly promote cartilage/bone regeneration when implanted into rabbit osteochondral defects for 8 and 12 weeks, displaying bi-lineage bioactivities.
Conclusion: The 3D-printed Mo-BGC scaffolds with bi-lineage bioactivities and activated anabolic responses could offer an effective strategy for cartilage/bone interface regeneration.
