Osteochondral graft fixation using a bioresorbable bone cement.
Abstract: Multiple osteochondral grafts can be used to resurface large joint defects in both humans and horses. In humans, immediate postoperative weight bearing can be prevented, however in the equine, it is unavoidable. Early weight bearing can create detrimental graft micromotion. The aim of this study was to investigate the role of a bioresorbable cement in improving the initial stability of multiple osteochondral graft repairs of large subchondral cystic lesions in the horse. Configurations employed for filling a 20mm diameter cylindrical defect included: (A) twelve 4.5mm diameter grafts with cement, (B) five 6.5mm diameter grafts with cement, (C) four each of 4.5mm and 6.5mm grafts with cement and (D) cement only. Intact bone slices (E) were also tested. Push-out tests were used to quantify construct to host sidewall interface fixation. Configuration (A) proved clinically impractical (n=3). Configurations (B) (n=6), and (C) (n=4) had statistically similar interface stiffnesses and failure stresses (43+/-8 and 30+/-12 MPa and 0.96+/-0.1 and 1.2+/-0.3 Mpa, respectively) suggesting that they are equally susceptible to interface movement in the immediate postoperative period. By way of comparison, defects filled only with cement had an average stiffness of 53+/-7MPa and failure stress of 1.8+/-0.3 MPa (n=6) while the intact femoral condyle demonstrated a stiffness of 108+/-7 MPa and failure stress of 18+/-0.4 MPa (n=6). Cement augmentation improved immediate postoperative stability of multiple osteochondral graft constructs over uncemented constructs, although in all cases the observed moduli of elasticity and yield stress values were lower than those observed for cement only and intact bone test specimens. (all numbers are mean+/-SEM).
Publication Date: 2006-01-04 PubMed ID: 16388810DOI: 10.1016/j.jbiomech.2005.10.007Google Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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This research investigates how bioresorbable cement can enhance the stability of multiple bone grafts in horses during initial postoperative periods. The focus is on treating large subchondral cystic lesions, comparing the effectiveness of different graft configurations and cement-only treatments.
Introduction to the Research and Overall Aim
- This research focuses on addressing a significant issue in orthopedic procedures for horses. Namely, horses cannot avoid bearing weight post-surgery, which can cause micromotion in the grafts used to repair large joint defects. Such micromotion can be harmful to the graft.
- The researchers aim to find out whether bioresorbable cement (a material that can be absorbed by the body) can enhance initial stability in osteochondral grafts – grafts made up of both bone and cartilage. This stability is sorely needed in the immediate aftermath of surgical operations.
Graft Configurations and Testing Method
- A variety of graft configurations were tested in order to fill a 20mm diameter cylindrical defect. These configurations included twelve 4.5mm diameter grafts with cement, five 6.5mm diameter grafts with cement, four each of 4.5mm and 6.5mm grafts with cement, and a defect filled solely with cement. Also examined were intact bone slices.
- The efficacy of these configurations was then determined through push-out tests, which provided a measure of how strongly the graft (or cement) was fixed to the host sidewall interface.
Results and Implications
- The configuration consisting of twelve 4.5mm diameter grafts was found to be impractical. However, the other two configurations – five 6.5mm diameter grafts and a mixture of 4.5mm and 6.5mm grafts – exhibited similar stiffnesses and failure stresses. This suggests that these configurations have comparable susceptibility to micromotion in the postoperative phase.
- Compared to these, defects filled exclusively with cement demonstrated higher stiffness and failure stress levels. However, both these measurements were lower than what was observed for intact bone specimens.
- The key finding of this study is that using cement to fix multiple osteochondral grafts can improve postoperative stability, although the moduli of elasticity and yield stress values still fell short of the benchmarks set by cement-only and intact bone trials.
Cite This Article
APA
Changoor A, Hurtig MB, John Runciman R.
(2006).
Osteochondral graft fixation using a bioresorbable bone cement.
J Biomech, 39(15), 2887-2892.
https://doi.org/10.1016/j.jbiomech.2005.10.007 Publication
Researcher Affiliations
- School of Engineering, University of Guelph, Guelph ON, Canada N1G 2W1.
MeSH Terms
- Absorbable Implants / standards
- Animals
- Bone Cements / standards
- Bone Substitutes
- Cartilage
- Cementation / standards
- Elasticity
- Horses
- Materials Testing
- Weight-Bearing
Citations
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