Subchondral defects in caprine femora augmented with in situ setting hydroxyapatite cement, polymethylmethacrylate, or autogenous bone graft: Biomechanical and histomorphological analysis after two-years

Robert D. Welch, B. Hudson Berry, Kevin Crawford, Hong Zhang, Mark Zobitz, Dwight Bronson, Sumant Krishnan

Research output: Contribution to journalArticle

45 Scopus citations

Abstract

Juxta-articular defects pose significant challenges due to the high risk of fracture of the subchondral plate and articular cartilage. We evaluated the mechanical and histomorphological repair process of caprine subchondral femoral defects augmented with either a bioresorbable in situ setting hydroxyapatite cement (HAC), polymethylmethacrylate (PMMA), autogenous bone graft (AG), or left empty. Twelve-mm subchondral defects were made bilaterally in the medial femoral condyles of skeletally mature goats and augmented with a test material or left empty. Femurs were harvested at varying time periods out to 2 years and evaluated for subchondral stiffness and histomorphological indices. Several defects augmented using autograft or left empty sustained focal fracture of the subchondral plate. No HAC or PMMA augmented defects showed evidence of subchondral fracture. The HAC and PMMA augmented defects showed comparable stiffness at all time points. The mean volume fraction of HAC remaining within the defects progressively decreased from 96% at 24 h to 38% at 2 years. The new bone replacing the HAC appeared to have normal physiological architecture and orientation. In situ setting hydroxyapatite cement may be a viable alternative for the repair of subchondral defects with an important advantage that while undergoing gradual resorption and replacement with host bone, mechanical integrity of the skeletal defect is maintained.

Original languageEnglish (US)
Pages (from-to)464-472
Number of pages9
JournalJournal of Orthopaedic Research
Volume20
Issue number3
DOIs
Publication statusPublished - 2002

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Keywords

  • Bone defect
  • Bone graft
  • Bone substitute
  • Histomorphometry
  • Polymethylmethacrylate

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

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