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Document Title: Ahmad-AJSM-Mar01
Article Title: Biomechanical and topographic considerations for autologous osteochondral grafting in the knee.
Author: Christopher S. Ahmad, Zohara A. Cohen, William N. Levine, Gerard A. Ateshian, Van C. Mow.
Publication: The American Journal of Sports Medicine
ISSN: 03635465
Date: March-April 2001.
(Figures included. Reference-denoting numbers appear in the same point size as document text.)
Volume: 29
Issue: 2
Pages: 201-206
Key Words: Knee, sports medicine, surgery, cartilage, grafts, chondral, biomechanics
ABSTRACT
This study characterizes the donor and recipient sites involved in osteochondral autograft surgery of the knee with respect to articular cartilage contact pressure, articular surface curvature, and cartilage thickness. Five cadaveric knees were tested in an open chain activity simulation and kinematic data were obtained at incremental knee flexion angles from 0 deg to 110 deg. Surface curvature, cartilage thickness, and contact pressure were determined using a stereophotogrammetry method. In all knees, the medial trochlea, intercondylar notch, and lateral trochlea demonstrated nonloadbearing regions. Donor sites from the distal-medial trochlea were totally nonloadbearing. For the intercondylar notch, lateral trochlea, and proximal-medial trochlea, however, the nonloadbearing areas were small, and typical donor sites in these areas partially encroached into adjacent loadbearing areas. The lateral trochlea (77.1 1/m) was more highly curved than the typical recipient sites of the central trochlea (23.3 1/m), medial femoral condyle (46.8 1/m), and lateral femoral condyles (42.9 1/m) (P < 0.05). Overall, the donor sites had similar cartilage thickness (average, 2.1 mm) when compared with the typical recipient sites (average, 2.5 mm). The lateral trochlea and medial trochlea curvatures were found to better match the recipient sites on the femoral condyles, while the intercondylar notch better matched the recipient sites of the central trochlea. The distal-medial trochlea was found to have the advantage of being nonloadbearing. Preoperative planning using the data presented will assist in more conforming, congruent grafts, thereby maximizing biomechanical function.
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