Evaluation of Gateshead carbon fibre rod as an implant material for repair of osteochondral defects: a morphological and mechanical study in the rabbit knee

Abstract

Use of the Gateshead carbon fibre rod system remains controversial. Although it has been shown to enhance the repair of lesions in load bearing areas of convex articular surfaces, there is a lack of evidence to support the claim that it provides an inert scaffold for ingrowth of organised fibrous tissue, and thereby increasing the rate and quality of articular surface regeneration. This study examined osteochondral repair following implantation of a Gateshead rod in the femoral condyles of 25 rabbits for up to 32 weeks, using radiology, histology, scanning electron microscopy and mechanical testing. The repaired fibrocartilaginous surface layer was found to be persistently softer than the normal control and some repaired surfaces were worn, exposing the rod at 32 weeks. Whilst fibrous tissue grew into the outer braided sheath of the rod, the core remained impervious. The rod appeared to act as a space occupier, initially providing better subsurface support than found in natural healing. In the long term, however, it prevented subchondral bone restoration and re-establishment of the normal osteochondral junction, resulting in a quality of repair which did not differ from that found in naturally healing defects.