Reconstruction of fullthickness cartilage defects by transfer of pedincullated periosteal autografts under the influence of intermittent active motion experimental study with rats

Abstract

The purpose of this study was to determine the chondrogenic potential of pedincuflated intra-articular autografts of periosteum under the influence of intermittent active motion. A pedicullated graft of periosteum (including the cambium Iayer) was prepared from the anterior aspect of the distal end of the femur. Five by ten mm rectangular periosteum Was stripped of the femur. The distal articular edge of this periosteum Was the pedicle and Ieft intact. Then the stripped periosteum was turned round to the articular cavity and sutured (with its cambium Iayer facing into the joint) to the base of a full-thickness defects on the pateflar groove of the right knee joint in ten rabbits. The Ieft knees were the control. The same full-thickness articular cartilage defect of the patellar groove was created in each Ieft knee joint. The rabbits were randomly treated postoperatively by intermittent active motion in a room. Five rabbits were killed at the sixth week and the other five rabbits were killed at the ninth week postoperatively. The regenerated tissue from each rabbit was analysed macroscopically and histologically. After the sixth and ninth weeks, full-thickness defects of right knees were covered with excellent cartilaginous tissue macroscopically and these findings were supported microscopically. No regeneration was observed in the control knees (p<0.001 ). In conclusion, this study demonstrated chondrogenic potantial and good resurfacing characteristics of pedincuflated periosteal autografts applied to full-thickness articular defects. Further investigation is worth being done.

Özet

Bu deneysel çalışmada pediküllü periost otogreftlerinin intermitan aktif hareket etkisi altında, kondrojenik potansiyelinin araştırılması ile ilgili deneysel incelemeler yapılmıştır. Tavşanların sağ femurları deney grubu olarak alınmış ve distal bölge anteriorundan kambiyum tabakası içerecek şekilde periost hazırlanmıştır. HazırIanan periostun distal kenan pedikül anlamında intakt bırakılmış ve patellar oluğun proksimalinde oluşturulan tam kıkırdak defektini kapatacak şekilde eklem içine transfer edilmiştir. Tavşanların sol dizleri kontrol grubu olarak alınmış ve kıkırdak defekti benzer şekilde oluşturulduktan sonra kapatılmıştır. Ameliyatlardan sonra oda içerisinde serbest olarak hareketlerine izin verilen toplam 10 adet tavşının beşi ameliyat sonrası 6. haftada, diğer beşi de 9. haftada öldürülmüş, elde edilen femurların patellar olukları üzerinde makroskopik ve mikroskopik incelemeler yapılmıştır. Yapılan incelemeler ışığında kıkırdak defektlerinin pediküllü periost transferIeri ile intermiten hareket etkisi altında mükemmelen onarılabileceği gösterilmiş (p