Suitability of Minced Cartilage From Osteochondral Lesions of the Talus for Immediate Autograft Reimplantation.

Autor: Williamson ERC; University of Rochester Department of Orthopaedics, Rochester, NY, USA., Zhang Z; Institute for Foot and Ankle Reconstruction at Mercy, Baltimore, MD, USA., Motsay M; Institute for Foot and Ankle Reconstruction at Mercy, Baltimore, MD, USA., Manchester M; Institute for Foot and Ankle Reconstruction at Mercy, Baltimore, MD, USA., Campbell JT; Institute for Foot and Ankle Reconstruction at Mercy, Baltimore, MD, USA., Cerrato RA; Institute for Foot and Ankle Reconstruction at Mercy, Baltimore, MD, USA., Maloney PJ; Institute for Foot and Ankle Reconstruction at Mercy, Baltimore, MD, USA., Schon LC; Institute for Foot and Ankle Reconstruction at Mercy, Baltimore, MD, USA., Jeng CL; Institute for Foot and Ankle Reconstruction at Mercy, Baltimore, MD, USA.
Jazyk: angličtina
Zdroj: Foot & ankle orthopaedics [Foot Ankle Orthop] 2024 Sep 30; Vol. 9 (3), pp. 24730114241278967. Date of Electronic Publication: 2024 Sep 30 (Print Publication: 2024).
DOI: 10.1177/24730114241278967
Abstrakt: Background: Particulated autograft cartilage implantation is a surgical technique that has been previously described for the repair of osteochondral lesions of the talus (OLT). It uses cartilage fragments harvested from the OLT that are minced into 1-2-mm 3 fragments and then immediately reimplanted back into the chondral defect and sealed with fibrin glue during a single-stage surgery. The purpose of this study was to characterize the suitability of these minced cartilage fragments as immediate autograft for the treatment of OLTs.
Methods: Thirty-one patients undergoing primary arthroscopic surgery for their OLT consented to have their loose or damaged cartilage fragments removed and analyzed in the laboratory. Harvested specimens were minced into 1- to 2-mm 3 fragments and cell count, cell density, and cell viability were determined. In addition, physical characteristics of the OLT lesion were recorded intraoperatively and analyzed including size, location, Outerbridge chondromalacia grade of the surrounding cartilage, density of underlying bone, and whether the surgeon thought the OLT was primarily hyaline or fibrocartilage.
Results: An average of 419 000 cells was able to be obtained from the harvested OLT fragments. The cells were 71.2% viable after mincing. Specimens from younger patients and from lesions with worse chondromalacia adjacent to the OLT had significantly higher cell numbers. Those from lateral lesions and with worse neighboring chondromalacia had a significantly higher cell density. None of the remaining physical OLT characteristics studied seemed to significantly affect cell number or viability.
Conclusion: A large number of viable cells are available for immediate autografting by removing the loose or damaged cartilage from an OLT and mincing it into 1- to 2-mm 3 fragments. These can be reimplanted into the chondral defect in a single-stage surgery. Future clinical studies are needed to determine if the addition of these live autologous cells either alone or in conjunction with other techniques significantly improves the quality of the repair tissue and clinical outcomes.
Level of Evidence: Level IV, case series.
Competing Interests: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: John T. Campbell, MD, reports research grant from Paragon28; OMEGA educational grant; AOFAS fellowship grant; editorial board, Foot & Ankle International; and chair, AOFAS Fellowship Match & Accreditation Committee. Rebecca A. Cerrato, MD, reports consultancy fees from Stryker and Acumed. Patrick J. Maloney, MD, reports consultancy fees from Arthrex and Paragon28; institutional research support from Arthrex, Paragon28, and Stryker. Clifford L. Jeng, MD, reports consultancy fees from Smith & Nephew. Disclosure forms for all authors are available online.
(© The Author(s) 2024.)
Databáze: MEDLINE
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