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Osteochondral Grafting: Effect of Graft Alignment, Material Properties, and Articular Geometry
Osteochondral grafting for cartilage lesions is an attractive surgical procedure; however, the clinical results have not always been successful. Surgical recommendations differ with respect to donor site and graft placement technique. No clear biomechanical analysis of these surgical options has bee...
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Formato: | Texto |
Lenguaje: | English |
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Bentham Open
2009
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729389/ https://www.ncbi.nlm.nih.gov/pubmed/19696917 http://dx.doi.org/10.2174/1874325000903010061 |
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author | D. D’Lima, Darryl C. Chen, Peter W. Colwell Jr., Clifford |
author_facet | D. D’Lima, Darryl C. Chen, Peter W. Colwell Jr., Clifford |
author_sort | D. D’Lima, Darryl |
collection | PubMed |
description | Osteochondral grafting for cartilage lesions is an attractive surgical procedure; however, the clinical results have not always been successful. Surgical recommendations differ with respect to donor site and graft placement technique. No clear biomechanical analysis of these surgical options has been reported. We hypothesized that differences in graft placement, graft biomechanical properties, and graft topography affect cartilage stresses and strains. A finite element model of articular cartilage and meniscus in a normal knee was constructed. The model was used to analyze the magnitude and the distribution of contact stresses, von Mises stresses, and compressive strains in the intact knee, after creation of an 8-mm diameter osteochondral defect, and after osteochondral grafting of the defect. The effects of graft placement, articular surface topography, and biomechanical properties were evaluated. The osteochondral defect generated minimal changes in peak contact stress (3.6 MPa) relative to the intact condition (3.4 MPa) but significantly increased peak von Mises stress (by 110%) and peak compressive strain (by 63%). A perfectly matched graft restored stresses and strains to near intact conditions. Leaving the graft proud by 0.5 mm generated the greatest increase in local stresses (peak contact stresses = 6.7 MPa). Reducing graft stiffness and curvature of articular surface had lesser effects on local stresses. Graft alignment, graft biomechanical properties, and graft topography all affected cartilage stresses and strains. Contact stresses, von Mises stresses, and compressive strains are biomechanical markers for potential tissue damage and cell death. Leaving the graft proud tends to jeopardize the graft by increasing the stresses and strains on the graft. From a biomechanical perspective, the ideal surgical procedure is a perfectly aligned graft with reasonably matched articular cartilage surface from a lower load-bearing region of the knee. |
format | Text |
id | pubmed-2729389 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2009 |
publisher | Bentham Open |
record_format | MEDLINE/PubMed |
spelling | pubmed-27293892009-08-20 Osteochondral Grafting: Effect of Graft Alignment, Material Properties, and Articular Geometry D. D’Lima, Darryl C. Chen, Peter W. Colwell Jr., Clifford Open Orthop J Article Osteochondral grafting for cartilage lesions is an attractive surgical procedure; however, the clinical results have not always been successful. Surgical recommendations differ with respect to donor site and graft placement technique. No clear biomechanical analysis of these surgical options has been reported. We hypothesized that differences in graft placement, graft biomechanical properties, and graft topography affect cartilage stresses and strains. A finite element model of articular cartilage and meniscus in a normal knee was constructed. The model was used to analyze the magnitude and the distribution of contact stresses, von Mises stresses, and compressive strains in the intact knee, after creation of an 8-mm diameter osteochondral defect, and after osteochondral grafting of the defect. The effects of graft placement, articular surface topography, and biomechanical properties were evaluated. The osteochondral defect generated minimal changes in peak contact stress (3.6 MPa) relative to the intact condition (3.4 MPa) but significantly increased peak von Mises stress (by 110%) and peak compressive strain (by 63%). A perfectly matched graft restored stresses and strains to near intact conditions. Leaving the graft proud by 0.5 mm generated the greatest increase in local stresses (peak contact stresses = 6.7 MPa). Reducing graft stiffness and curvature of articular surface had lesser effects on local stresses. Graft alignment, graft biomechanical properties, and graft topography all affected cartilage stresses and strains. Contact stresses, von Mises stresses, and compressive strains are biomechanical markers for potential tissue damage and cell death. Leaving the graft proud tends to jeopardize the graft by increasing the stresses and strains on the graft. From a biomechanical perspective, the ideal surgical procedure is a perfectly aligned graft with reasonably matched articular cartilage surface from a lower load-bearing region of the knee. Bentham Open 2009-08-06 /pmc/articles/PMC2729389/ /pubmed/19696917 http://dx.doi.org/10.2174/1874325000903010061 Text en © D’Lima et al.; Licensee Bentham Open. http://creativecommons.org/licenses/by-nc/3.0/ This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited. |
spellingShingle | Article D. D’Lima, Darryl C. Chen, Peter W. Colwell Jr., Clifford Osteochondral Grafting: Effect of Graft Alignment, Material Properties, and Articular Geometry |
title | Osteochondral Grafting: Effect of Graft Alignment, Material Properties, and Articular Geometry |
title_full | Osteochondral Grafting: Effect of Graft Alignment, Material Properties, and Articular Geometry |
title_fullStr | Osteochondral Grafting: Effect of Graft Alignment, Material Properties, and Articular Geometry |
title_full_unstemmed | Osteochondral Grafting: Effect of Graft Alignment, Material Properties, and Articular Geometry |
title_short | Osteochondral Grafting: Effect of Graft Alignment, Material Properties, and Articular Geometry |
title_sort | osteochondral grafting: effect of graft alignment, material properties, and articular geometry |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2729389/ https://www.ncbi.nlm.nih.gov/pubmed/19696917 http://dx.doi.org/10.2174/1874325000903010061 |
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