Transplantation of the Autogenous Chondrocyte Graft to Physeal Defects: an Experimental Study in Pigs

Abstract

The aim of the experiment was to evaluate the possibility of preventing bone bridge formation in damaged distal femoral physis using implantation of autogenous chondrocyte graft. Ten pigs were used in the study. In each pig, a sample of cartilage of 3 × 3 mm in diameter was taken from non-weight-bearing surface of the lateral femoral condyle and used to culture chondrocytes for the preparation of the autogenous chondrocyte graft.Fourteen days later, a canal of 4 mm diameter was drilled through the distal femoral physis in the area of the lateral condyle. This canal was then filled with the autogenous chondrocyte graft. The same defect, left unfilled, was created in the physis of the medial condyle. One animal succumbed during the transplantation of the chondrocyte graft due to complications of anaesthesia.Remaining 9 animals were euthanised and examined histologically with respect to the healing of the transplant in the area of the growth plate. In all 9 cases the graft was healed in the distal femoral physis. Bone bridges were formed in canals unfilled with the autogenous chondrocyte graft.We conclude that transplantation of the autogenous chondrocyte graft into iatrogenically damaged physis in pigs can prevent bone bridge formation and growth arrest. This finding may have clinical implications in potential transplantation of chondrocyte autografts in children. Growth plate, injury, bone bridge, pigGrowth plate fractures in children, in particular those ones of types III to V according to the classification by Salter-Harris (1963), belong to injuries of poor prognosis. Damage to the regular chondrogenesis in the physis can result in altered growth of the bone affected due to the formation of a bone bridge. In dependence on its location we recognise either a peripheral bone bridge resulting in angular deformities of the bone affected, a central bone bridge shortening the bone without its angular deformity or a combined kind of a bridge causing both angular deformities and shortening of the bone (Rockwood et al. 1984). Combined bone bridges are least favourable for the patient (Rockwood et al. 1984). Iatrogenic damage to the physis during surgical repositioning of a physeal fracture can lead to the formation of osteonecrotic bone bridges and then can form a bone bridge in the fissure after incomplete repositioning of fragments (von Laer 1984). Clinical consequences of physeal bone bridging are often very serious (Bak and Boeckstyns 1997) and their therapy includes complex corrective surgeries (Hove and Engesaeter 1997) or complicated resections of bone bridges (Langenskiold 1981).Trauma to the distal femoral physis is a typical example of injury to the growth plate in children. This injury, common in preadolescents and adolescents, is not so frequent but can

Comparison of Preventive and Therapeutic Transplantations of Allogeneic Mesenchymal Stem Cells in Healing of the Distal Femoral Growth Plate Cartilage Defects in Miniature Pigs

“…In the experiments the filling of the growth cartilage defects with chondrocytes or stem cells was mostly performed immediately after they were created (Ahn et al 2004;Chen et al 2003;Gál et al 2002a;Plánka et al 2007). It was thus a prevention of the bone bridge formation, as in the case of animals of Group A in this study.…”

“…Preventive interventions preventing the bone bridge formation focus on filling the occurred growth cartilage defect mainly with an allogeneic fat graft (Langenskiöld 1981), a graft from the fascia or tendon, or silicone substitutes (Macksoud and Bright 1989). Some studies point out the positive effect of autologous chondrocyte transplantation into the growth cartilage defect (Foster et al 1990;Lee et al 1998;Lennox et al 1983;Gál et al 2002a). In our previous studies we addressed the issue of transplantation of MSCs into the injured growth plates in pigs, mainly with the aim to find a suitable scaffold, and also to verify the possibilities and evaluate some aspects of autogenous and allogeneic transplantations of mesenchymal stem cells Gál et al 2007).…”

Healing of Large Segmental Bone Defect after Implantation of Autogenous Cancellous Bone Graft in Comparison to Hydroxyapatite and 0.5% Collagen Scaffold Combined with Mesenchymal Stem Cells

“…One of the most studied materials for this purpose is hydroxyapatite. The purpose of the scaffold is to control the degree of regeneration and the extent of tissue regeneration, or in case of need, to provide suitable environment for stem cells transplanted into given tissue defects (Chu et al 2000;Gál et al 2002;Gál et al 2007;Jančář et al 2007;Plánka et al 2007;Crha et al 2009). …”

Biomaterials and Stem Cells in the Treatment of Articular Cartilage, Meniscal, Physeal, Bone, Ligamentous and Tendineous Defects

“…Injuries of the growth cartilage of long limb bones lead in 5% of cases to a clinically significant bone bridge formation between epiphysis and metaphysis of the long bone (Gál et al 2002;Janarv et al 1998). At the same time, in approximately 25 -30% of cases the lengthwise bone growth is reduced and angular bone deformity developed (campbell et al 1959;Ford and Key 1956).…”

“…Prophylactic interventions preventing bone bridge formation focus on the filling of the occurred articular cartilage defect mainly with an allogeneic fatty graft, a graft from fascia or tendon, or by silicone substitutes (campbell et al 1959; Österman 1972). some studies indicate a positive effect of autologous chondrocyte transplantation to the growth cartilage defect (Gál et al 2002). The actual issues of current research include evaluation of the capacity of mesenchymal stem cells to heal physeal defects.…”