Topographic Matching of Selected Donor and Recipient Sites for Osteochondral Autografting of the Articular Surface of the Femoral Condyles

Abstract

The purpose of this study was to define the topography of the articular surface of the femoral condyles and to develop a method for computerized topographic matching of donor and recipient sites for osteochondral transplantation. The condyles of seven fresh cadaveric femurs were mounted on the rotating stage of a laser-based coordinate measuring machine. An anatomic coordinate system defining the articular surface of the condyles was created. Customized software was developed to allow selection and topographic matching of osteochondral graft donor and recipient sites from any location on the surface of the condyles. For cartilage defects within the weightbearing portions of the medial or lateral femoral condyles, grafts taken from sites from the most medial or lateral portions of the patellar groove provided a significantly better topographic match than did grafts taken from the central intercondylar notch.

Topographic Analysis of the Capitellum and Distal Femoral Condyle: Finding the Best Match for Treating Osteochondral Defects of the Humeral Capitellum

“…Failure to produce a congruous surface can lead to altered contact pressures, edge loading of the graft, impaired integration of host and graft, and possibly early failure. [19][20][21][22] Other factors that affect the success of the procedure include overall surface coverage, as well as side and shape of the osteochondral plugs. 23 Thus, for successful osteochondral grafting, an exact anatomic restoration of the joint surface is essential.…”

“…Smaller defects result in less topographic mismatch after restoration compared with larger defects. 19 Moreover, OCD lesions are generally limited to 10 mm in diameter or less, and larger defects are best treated with multiple plugs or fixation. 2,29 Finally, we investigated the shape of the bony surface and did not consider the cartilage thickness.…”

Automated Planning of Computer Assisted Mosaic Arthroplasty

“…One study determined the congruity between the surfaces at a harvest site and a donor site by finding the rigid transformation between the surfaces that minimized the RMS error. The study applied this measure to seven cadaveric knees to propose the best harvest sites for particular defect sites [15]. Another study on six dog femurs used similar topographic matching and considered different plug diameters, finding that larger plug diameters had fewer good harvest sites [16].…”

“…This could be done automatically (but currently is not) by incorporating known good donor sites [15,16].…”

Tissue Engineering von Knorpelersatzgewebe – Mechanische Stimulation in der In-vitro-Kultivierung von humanen Chondrozyten

“…(Yamashita et al, 1985), arthroskopisch erstmals 1993 (Matsusue et al, 1993) (Pearce et al, 2001). In Bezug auf die Wahl der Spenderstelle hat sich gezeigt, dass der hyaline Knorpel der Gewicht tragenden Kondylenareale am ehesten dem des medialen und lateralen Patellagleitlagers entspricht (Bartz et al, 2001 (Koay et al, 2008), biochemische Signale (Grimaud et al, 2002;Chubinskaya et al, 2007;Davies et al, 2008) und nicht zuletzt mechanische Stimulation (Kisiday et al, 2004) . Abbildung 9 stellt das ACT-Verfahren schematisch dar, Abbildung 10 die korrespondierenden intraoperativen Bilder.…”