Intraarticular location predicts cartilage filling and subchondral bone changes in a chondral defect

Abstract

Background and purpose The natural history of, and predictive factors for outcome of cartilage restoration in chondral defects are poorly understood. We investigated the natural history of cartilage filling subchondral bone changes, comparing defects at two locations in the rabbit knee.

Animals and methods In New Zealand rabbits aged 22 weeks, a 4-mm pure chondral defect (ICRS grade 3b) was created in the patella of one knee and in the medial femoral condyle of the other. A stereo microscope was used to optimize the preparation of the defects. The animals were killed 12, 24, and 36 weeks after surgery. Defect filling and the density of subchondral mineralized tissue was estimated using Analysis Pro software on micrographed histological sections.

Results The mean filling of the patellar defects was more than twice that of the medial femoral condylar defects at 24 and 36 weeks of follow-up. There was a statistically significant increase in filling from 24 to 36 weeks after surgery at both locations.

The density of subchondral mineralized tissue beneath the defects subsided with time in the patellas, in contrast to the density in the medial femoral condyles, which remained unchanged.

Interpretation The intraarticular location is a predictive factor for spontaneous filling and subchondral bone changes of chondral defects corresponding to ICRS grade 3b. Disregarding location, the spontaneous filling increased with long-term follow-up. This should be considered when evaluating aspects of cartilage restoration.

All authors contributed to planning and design of the study, interpretation of the data, and writing of the manuscript. SH, AÅ, SL, and SS were involved in animal care and surgery. SH, Aå, SL, SS, and FPR contributed to specimen and tissue handling. SH and FPR did the histological analysis and SH performed the statistical analysis under the guidance of our statistical advisor.

The authors thank Dr Ingar Holme for advice on statistics, bioengineer Aileen Murdoch Larsen for technical assistance, and Dr Dag R Sørensen and his staff at the Center for Comparative Medicine for technical assistance and for taking care of the animals. The study was supported by grants from Oslo Sports Trauma Research Center (OSTRC), which is financed by the South-Eastern Norway Regional Health Authority, the Royal Norwegian Ministry of Education and Research, the Norwegian Olympic Committee and Confederation of Sport, and Norsk Tipping.

No competing interests declared.