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Diermeier, Theresa; Venjakob, Arne; Byrne, Kevin; Burgkart, Rainer; Foehr, Peter; Milz, Stefan; Imhoff, Andreas B. and Vogt, Stephan (2020): Effects of focal metallic implants on opposing cartilage - an in-vitro study with an abrasion test machine. In: BMC Musculoskeletal Disorders, Vol. 21, No. 1

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BackgroundFor focal cartilage defects, biological repair might be ineffective in patients over 45years. A focal metallic implant (FMI) (Hemi-CAP Arthrosurface Inc., Franklin, MA, USA) was designed to reduce symptoms. The aim of this study was to evaluate the effects of a FMI on the opposing tibial cartilage in a biomechanical set-up. It is hypothesized that a FMI would not damage the opposing cartilage under physiological loading conditions.MethodsAn abrasion machine was used to test the effects of cyclic loading on osteochondral plugs. The machine applied a compressive load of 33N and sheared the samples 10mm in the anteroposterior direction by 1Hz. Tibial osteochondral plugs from porcine knees were placed in opposition to a FMI and cycled for 1 or 6h. After testing each plug was fixed, stained and evaluated for cartilage damage.ResultsAfter 1h of loading (n=6), none of the osteochondral plugs showed histologic signs of degradation. After 6h of loading (n=6) three samples had histologic signs of injury in the tangential zone (grade 1) and one had signs of injury in the transitional and deep zones (grade 2). Exploration for 6h resulted in significant more cartilage damage compared to the shorter exploration time (p=0.06). However, no significant difference between saline and hyaluronic acid was evident (p=0.55).ConclusionUnder physiologic loading conditions, contact with a FMI leads to cartilage damage in the opposing articular cartilage in six hours. In clinical practice, a thorough analysis of pre-existing defects on the opposing cartilage is recommended when FMI is considered.

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