Biomechanical Properties of Repair Cartilage Tissue Are Superior following Microdrilling Compared to Microfracturing in Critical Size Cartilage Defects

Florian Pohlig, Michael Wittek, Anne von Thaden, Ulrich Lenze, Claudio Glowalla, Philipp Minzlaff, Rainer Burgkart, Peter Michael Prodinger

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background/Aim: Common surgical treatment options for large focal chondral defects (FCDs) in the knee include microfracturing (MFX) and microdrilling (DRL). Despite numerous studies addressing MFX and DRL of FDCs, no in vivo study has focused on biomechanical analysis of repair cartilage tissue in critical size FCDs with different amounts of holes and penetration depths. Materials and methods: Two round FCDs (d=6 mm) were created on the medial femoral condyle in 33 adult merino sheep. All 66 defects were randomly assigned to 1 control or 4 different study groups: 1) MFX1, 3 holes, 2 mm depth; 2) MFX2, 3 holes, 4 mm depth; 3) DRL1, 3 holes, 4 mm depth; and 4) DRL2, 6 holes, 4 mm depth. Animals were followed up for 1 year. Following euthanasia, quantitative optical analysis of defect filling was performed. Biomechanical properties were analysed with microindentation and calculation of the elastic modulus. Results: Quantitative assessment of defect filling showed significantly better results in all treatment groups compared to untreated FCDs in the control group (p<0.001), with the best results for DRL2 (84.2% filling). The elastic modulus of repair cartilage tissue in the DRL1 and DRL2 groups was comparable to the adjacent native hyaline cartilage, while significantly inferior results were identified in both MFX groups (MFX1: p=0.002; MFX2: p<0.001). Conclusion: More defect filling and better biomechanical properties of the repair cartilage tissue were identified for DRL compared to MFX, with the best results for 6 holes and 4 mm of penetration depth. These findings are in contrast to the current clinical practice with MFX as the gold standard and suggest a clinical return to DRL.

Original languageEnglish
Pages (from-to)565-573
Number of pages9
JournalIn Vivo
Volume37
Issue number2
DOIs
StatePublished - Mar 2023
Externally publishedYes

Keywords

  • DRL
  • FCD
  • Knee
  • MFX
  • cartilage
  • defect
  • drilling
  • focal chondral defect
  • microfracturing
  • regeneration

Fingerprint

Dive into the research topics of 'Biomechanical Properties of Repair Cartilage Tissue Are Superior following Microdrilling Compared to Microfracturing in Critical Size Cartilage Defects'. Together they form a unique fingerprint.

Cite this