Abstract
The cartilage-flow phenomenon has been frequently described but not in connection with transplantation procedures for treatment of cartilage lesions. Consequently, we examined this particular phenomenon in an experimental sheep model originally set up to study the use of perichondrial grafts for repair of full-thickness cartilage lesions. Osteochondral lesions were made in nonweight-bearing and weight-bearing areas of knee joints in 36 sheep. The defects were filled with autologous rib perichondrial grafts and secured by either collagen sponges or fibrin glue (n = 24 animals). Defects without perichondrial grafts served as controls (n = 12 animals). Following 1 week of immobilisation of the operated leg, the plaster was removed, and the animals were allowed to move freely. Animals were killed after 4, 8, 12 and 16 weeks. Grafts including rims of original surrounding cartilage and bone were removed and investigated by means of macroscopy, histology and micromorphology, including scanning electron microscopy and analysis under polarized light. Cartilage flow was observed in all specimens by 4 weeks after drilling the defects, independent of the weight-bearing condition. These flow formations exhibited a bending of the collagen fibres centrally into the defects, reduction of metachromasia, cell cluster formation and areas of reduced cell density. Time-dependent flow formations were observed related to the weight-bearing condition and whether or not the defects had been grafted. In grafted, non-weight-bearing defects further cartilage flow was stopped 8 weeks after transplantation by the growing perichondrial transplants, which had filled the defects completely. In contrast, control defects exhibited further flow formations in both areas. The same was observed in grafted defects in the weight-bearing area. In defects without complete filling as not enough spontaneously growing fibrous tissue had arisen from the bottom of the defects, two different observations were made; either the defects exhibited a fungiform mass of fibrous tissue that had overgrown the latteral flow formations, or the central mass of fibrous tissue was overgrown by the lateral flow formations. In conclusion, cartilage flow seems to be mechanically induced phenomenon at the rims of cartilage lesions that contributes little to the reduction of size of large osteochondral defects. There was no evidence for new cartilage proliferation or production of carilaginous matrix at the rims of the lesions.
Similar content being viewed by others
References
Amiel D, Harwood FL, Abel MF, Akeson WH (1985) Collagen types in neocartilage tissue resulting from rib periochondrial graft in an articular defect — a rapid semi-quantitative methodology. Collagen Rel Res 5:337–347
Amiel D, Coutts RD, Abel M, Stewart W, Harwood F, Akeson WH (1985) Rib perichondrial grafts for the repair of full-thickness articular-cartilage defects. J Bone Joint Surg [Am] 67:911–920
Baker B, Becker RO, Spadaro J (1974) A study of electrochemical enhancement of articular cartilage repair. Clin Orthop102:251–267
Beaver RJ, Mahomed M, Backstein D, Davis A, Zukor DJ, Gross AE (1992) Fresh osteochondral allografts for post-traumatic defects in the knee. A survivorship analysis. J Bone Joint Surg [Br] 74:105–110
Bentley G (1978) The surgical treatment of chondromalacia patellae. J Bone Joint Surg [Br] 60:74–81
Brown TD, Pope DF, Hale JE, Buckwalter JA, Brand RA (1991) Effects of osteochondral defect size on cartilage contact stress. J Orthop Res 9:559–567
Bruns J, Kersten P, Lierse W, Silbermann M (1992) Autologous rib perichondrial grafts in experimentally induced osteochondral lesions in the sheep-knee joint: morphological results. Virchows Archiv [A] 421:1–8
Calandruccio RA, Gilmer WS (1962) Proliferation, regeneration, and repair of articular cartilage of immature animals. J Bone Joint Surg [Am] 44:431–455
Convery FR, Akeson WH, Keown GH (1972) The repair of large osteochondral defects. Clin Orthop 82:253–262
Czitrom AA, Keating S, Gross AE (1990) The viability of articular cartilage in frensh osteochondral allografts after clinical transplantation. J Bone Joint Surg [Am] 72:574–581
Dürr W (1982) Autologe Knorpeltransplantation. Chirurg 53:206–210
Dustmann HO, Puhl W, Krempien B (1974) Die Zellteilung im Gelenkknorpel. Tierexerimentelle Untersuchungen. Arch Orthop Unfall Chir 79:171–182
Dustmann HO, Puhl W, Krempien B (1974) Das Phänomen der Cluster im Arthroseknorpel. Arch Orthop Unfall Chir 79:321–333
Fuller JA, Ghadially FN (1972) Ultrastructural observations on surgically produced partial thickness defects in articular cartilage. Clin Orthop 86:193–205
Ghadially FN, Fuller JA, Kirkaldy-Willis WH (1971) Ultrastructure of full-thickness defects in articular cartilage. Arch Pathol 92:356–369
Ghadially FN, Ailsby RL, Oryschak AF (1974) Scanning electron microscopy of superficial defects in articular cartilage. Ann Rheum Dis 33:327–332
Ghadially FN, Thomas I, Oryschak AF, Lalonde JM (1977) Long-term results of superficial defects in articular cartilage: a scanning electron-microscope study. J Pathol 121:213–217
Ghadially JA, Ghadially FN (1975) Evidence of cartilage flow in deep defects in articular cartilage. Virchows Arch [B] 18:193–204
Ghadially JA, Ghadially R, Ghadially FN (1977) Long-term results of deep defects in articular cartilage. A scanning electron microscope study. Virchows Arch [B] 25:125–136
Hesse W, Hesse I, Zech G (1975) Regressive und reparative Vorgänge nach experimenteller Transplantation von homologem Gelenkknorpel. Arch Orthop Unfall Chir 81:89–103
Homminga GN, Linden TJ van der, Terwindt-Rouwenhorst EAW (1989) Repair of articular defects by perichondrial grafts. Acta Orthop Scand 60:326–329
Homminga GN, Bulstra SK, Bouwmeester PM, Linden AJ van der (1990) Perichondrial grafting for cartilage lesions of the knee. J Bone Joint Surg [Br] 72:1003–1007
Hurtig MB, Fretz PB, Doige CE, Schnurr DL (1988) Effects of lesion size and location on equine articular cartilage repair. Can J Vet Res 52:137–146
Llinas A, McKellop HA, Marshall GJ, Sharpe F, Lu B, Kirchen M, Sarmiento A (1993) Healing and remodeling of articular incongruities in a rabbit fracture model. J Bone Joint Surg [Am] 75:1508–1523
Mankin HJ (1982) The response of articular cartilage to mechanical injury. J Bone Joint Surg [Am] 64:460–466
Meachim G, Roberts C (1971) Repair of the joint surface from subarticular tissue in the rabbit knee. J Anat 109:317–327
Mitchell N, Shepard N (1980) Healing of articular cartilage in intra-articular fractures in rabbits. J Bone Joint Surg [Am] 62:628–634
Mitchell N, Lee ER, Shepard N (1992) The clones of osteoarthritic cartilage. J Bone Joint Surg [Br] 74:33–38
Passl R, Plenk H, Sauer G, Spaengler HP, Radaszkiewicz T, Holle J (1976) Die reine homologe Gelenkknorpeltransplantation. Arch Orthop Unfall Chir 86:243–256
Puhl W (1974) Die Mikromorphologie gesunder Gelenkknorpeloberflächen. Z Orthop 112:262–272
Puhl W, Dustmann HO (1973) Die Reaktionen des Gelenkknorpels auf Verletzungen (Tierexperimentelle Untersuchungen). Z Orthop 111:494–497
Puhl W, Dustmann HO, Quosdorf U (1973) Tierexperimentelle Untersuchungen zur Regeneration des Gelenkknorpels. Arch Orthop Unfall Chir 79:352–365
Salter RB, Simmonds DF, Malcolm BW, Rumble EJ, McMichael D (1975) The effects of continuous passive motion on the healing of articular cartilage defects. J Bone Joint Surg [Am] 57:570–571
Salter RB, Simmonds DF, Malcolm BW, Rumble EJ, McMichael D, Clements ND (1980) The biological effect of continuous passive motion on the healing of full-thickness defects in articular cartilage. J Bone Joint Surg [Am] 62:1232–1251
Shahgaldi BF, Amis AA, Heatley FW, McDowell J, Bentley G (1991) Repair of cartilage lesions using biological implants. J Bone Joint Surg [Am] 73:57–64
Silbermann M, Frommer J (1974) Demonstration and distribution of acidic glycosaminoglycans in mouse secondary cartilage. Histochemistry 38:85–93
Silbermann M, Kadar T, Homung G (1977) Corticoid-induced changes in glucose metabolism of chondrocytes. Histochemistry 50:327–355
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Bruns, J., Kersten, P., Silbermann, M. et al. Cartilage-flow phenomenon and evidence for it in perichondrial grafting. Arch Orthop Trauma Surg 116, 66–73 (1997). https://doi.org/10.1007/BF00434104
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF00434104