Experimental and clinical aspects of combined method of replacement osteochondral defects of the knee

Abstract

Injuries and diseases of large joints occupy a leading place in the list of urgent problems of orthopedics. Various methods of treatment of this pathology are regularly offered in the literature, but most of them do not allow restoring a full-fledged hyaline cartilage.
 Background. To improve the results of organ-preserving treatment of patients with osteo-chondral defects of large joints.
 Methods. A prospective study was conducted on 30 large animals (60 knee joints) aged 1.5 to 3 years. We divided the animals into 3 groups of 10 individuals (20 joints) in each, based on the method of replacement of the osteo-chondral defect. In all cases, a full-layer defect formed from the hyaline cartilage by a mill with a diameter of 4.5 mm, depth of 7 mm with the capture of the subchondral bone in the medial condyle of the right thigh. Artificial defects restored by one of the following methods. The left joint considered a control joint and the defect formed by the same technique was not filled.
 Results. The result was evaluated in 1 month,3 months and 6 months viewing the nature and degree of defect fill. Specific volumes of such tissues as chondrocytes, cartilage matrix and the average depth of the defect from the thickness of the native cartilage are better in group 3, and connective tissue is less in group 3.
 Conclusion. In the group without defect replacement, the obtained data are comparable with the studies of other authors, according to which bone and cartilaginous defects practically do not regenerate on their own. Our proposed method with the use of extracellular collagen matrix, autocartilage and plate rich plasma is less aggressive in comparison with autochondroplasty and the result can be more stable compared to microfracturing or tunnelization.