Effects of focal metallic implants on opposing cartilage – an in-vitro study with an abrasion test machine

• Main Authors: Theresa Diermeier, Arne Venjakob, Kevin Byrne, Rainer Burgkart, Peter Foehr, Stefan Milz, Andreas B. Imhoff, Stephan Vogt
• Format: Article
• Language: English
• Published: BMC 2020-04-01
• Series: BMC Musculoskeletal Disorders
• Subjects: Cartilage; Knee; Focal metallic implant; Hemicap
• Online Access: http://link.springer.com/article/10.1186/s12891-020-03292-4

Abstract Background For focal cartilage defects, biological repair might be ineffective in patients over 45 years. 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. Methods An abrasion machine was used to test the effects of cyclic loading on osteochondral plugs. The machine applied a compressive load of 33 N and sheared the samples 10 mm in the anteroposterior direction by 1 Hz. Tibial osteochondral plugs from porcine knees were placed in opposition to a FMI and cycled for 1 or 6 h. After testing each plug was fixed, stained and evaluated for cartilage damage. Results After 1 h of loading (n = 6), none of the osteochondral plugs showed histologic signs of degradation. After 6 h 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 6 h 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). Conclusion Under 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.