Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Apr 21;21(1):261.
doi: 10.1186/s12891-020-03292-4.

Effects of focal metallic implants on opposing cartilage - an in-vitro study with an abrasion test machine

Theresa Diermeier  1 , Arne Venjakob  2   3 , Kevin Byrne  4 , Rainer Burgkart  5 , Peter Foehr  5 , Stefan Milz  6 , Andreas B Imhoff  2 , Stephan Vogt  2   7
Affiliations

Effects of focal metallic implants on opposing cartilage - an in-vitro study with an abrasion test machine

Theresa Diermeier et al. BMC Musculoskelet Disord. .

Abstract

Background: For focal cartilage defects, biological repair might be ineffective in patients over 45 years. A focal metallic implant (FMI) (Hemi-CAP Arthrosurface Inc., Franklin, MA, USA) was designed to reduce symptoms. The aim of this study was to evaluate the effects of a FMI on the opposing tibial cartilage in a biomechanical set-up. It is hypothesized that a FMI would not damage the opposing cartilage under physiological loading conditions.

Methods: An abrasion machine was used to test the effects of cyclic loading on osteochondral plugs. The machine applied a compressive load of 33 N and sheared the samples 10 mm in the anteroposterior direction by 1 Hz. Tibial osteochondral plugs from porcine knees were placed in opposition to a FMI and cycled for 1 or 6 h. After testing each plug was fixed, stained and evaluated for cartilage damage.

Results: After 1 h of loading (n = 6), none of the osteochondral plugs showed histologic signs of degradation. After 6 h of loading (n = 6) three samples had histologic signs of injury in the tangential zone (grade 1) and one had signs of injury in the transitional and deep zones (grade 2). Exploration for 6 h resulted in significant more cartilage damage compared to the shorter exploration time (p = 0.06). However, no significant difference between saline and hyaluronic acid was evident (p = 0.55).

Conclusion: Under physiologic loading conditions, contact with a FMI leads to cartilage damage in the opposing articular cartilage in six hours. In clinical practice, a thorough analysis of pre-existing defects on the opposing cartilage is recommended when FMI is considered.

Keywords: Cartilage; Focal metallic implant; Hemicap; Knee.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Experimental set-up with the FMI (asterix) at the bottom and the osteochondral plug (black arrow) on top
Fig. 2
Fig. 2
Scoring system for damage classification
Fig. 3
Fig. 3
Macroscopic picture of a specimen stained with ink according to Meachim [31] after tested for 6 h in hyaluronic acid. Left picture 0° perspective; right picture 90° perspective
Fig. 4
Fig. 4
Histologic pictures of specimens tested for 1 h in saline (a-c) and hyaluronic acid (Viscoseal Syringe, TRB Chemedica AG, Haar/Germany (d-e) without any cartilage defect. (Giemsa 5x)
Fig. 5
Fig. 5
Histologic picture of a specimen tested for 6 h in hyaluronic acid (Viscoseal Syringe, TRB Chemedica AG, Haar/Germany with a defect of the upper 25% of the transitional and radial zone (grade 2) (asterix). (Giemsa 5x)
See this image and copyright information in PMC

References

    1. Allaire R, Muriuki M, Gilbertson L, Harner CD. Biomechanical consequences of a tear of the posterior root of the medial meniscus. Similar to total meniscectomy. J Bone Joint Surg Am. 2008;90:1922–1931. doi: 10.2106/JBJS.G.00748. - DOI - PubMed
    1. Arno S, Bell CP, Uquillas C, Borukhov I, Walker PS. Tibiofemoral contact mechanics following a horizontal cleavage lesion in the posterior horn of the medial meniscus. J Orthop Res. 2015;33:584–590. doi: 10.1002/jor.22809. - DOI - PubMed
    1. Årøen A, Løken S, Heir S, Alvik E, Ekeland A, Granlund OG, et al. Articular cartilage lesions in 993 consecutive knee arthroscopies. Am J Sports Med. 2004;32:211–215. doi: 10.1177/0363546503259345. - DOI - PubMed
    1. Becher C, Huber R, Thermann H, Ezechieli L, Ostermeier S, Wellmann M, et al. Effects of a surface matching articular resurfacing device on tibiofemoral contact pressure: results from continuous dynamic flexion–extension cycles. Arch Orthop Trauma Surg. 2011;131:413–419. doi: 10.1007/s00402-010-1201-5. - DOI - PubMed
    1. Becher C, Huber R, Thermann H, Paessler HH, Skrbensky G. Effects of a contoured articular prosthetic device on tibiofemoral peak contact pressure: a biomechanical study. Knee Surg Sports Traumatol Arthrosc. 2008;16:56–63. doi: 10.1007/s00167-007-0416-7. - DOI - PMC - PubMed

LinkOut - more resources