Mechanical integrity of subchondral bone in osteochondral autografts and allografts.
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OBJECTIVE: To assess the influence of osteochondral graft preservation techniques on post-transplant biomechanics of graft and host subchondral bone in the knee joint. DESIGN: An experimental animal model (sheep), specifically the weight-bearing articular surface of the medial femoral condyle of the knee joints. INTERVENTION: Each sheep received, in the ipsilateral knee, an allograft that was (a) frozen without dimethyl sulfoxide (DMSO), (b) snap-frozen in liquid nitrogen or (c) frozen with DMSO. The contralateral knee received an autograft that was (a) snap-frozen, (b) treated with DMSO or (c) left untreated (fresh). MAIN OUTCOME MEASURES: Mechanical and material properties of bone, including maximal compression stress, modulus of elasticity and bone cores (from the graft centre and surrounding host bone). RESULTS: No significant differences were found in the mechanical properties of the subchondral bone under the graft, but there were significant changes in surrounding bone. Bone surrounding the grafts that were snap-frozen or frozen without DMSO was significantly stronger than the normal control bone. However, bone surrounding fresh autografts and cryoprotected allografts was not significantly different from normal control bone. CONCLUSIONS; The changes in the mechanical behaviour of the host bone may be associated with graft cell viability. The great stiffness of the subchondral host bone may have consequences for long-term graft integrity and for the development of degenerative osteoarthritis.
