Chondrocyte survival in osteochondral transplant cylinders depends on the harvesting technique

Int Orthop. 2016 Jul;40(7):1553-8. doi: 10.1007/s00264-015-3065-3. Epub 2015 Dec 11.

Abstract

Purpose: In autologous osteochondral transplantation, the edges of the harvested plug are particularly susceptible to mechanical or thermal damage to the chondrocytes. We hypothesised that the applied harvesting device has an impact on chondrocyte vitality.

Methods: Both knees of five blackhead sheep (ten knees) underwent open osteochondral plug harvesting with three different circular harvesting devices (osteoarticular transfer system harvester [OATS; diameter 8 mm; Arthrex, Munich, Germany], diamond cutter [DC; diameter 8.35 mm; Karl Storz, Tuttlingen, Germany] and hollow reamer with cutting crown [HRCC; diameter 7 mm; Dannoritzer, Tuttlingen, Germany]) from distinctly assigned anatomical sites of the knee joint. The rotary cutters (DC and HRCC) were either used with (+) or without cooling (-). Surgical cuts of the cartilage with a scalpel blade were chosen as control method. After cryotomy cutting, chondrocyte vitality was assessed using fluorescence microscopy and a Live/Dead assay.

Results: There were distinct patterns of chondrocyte vitality, with reproducible accumulations of dead chondrocytes along the harvesting edge. No statistical difference in chondrocyte survivorship was seen between the OATS technique and the control method, or between the HRCC+ technique and the control method (P > 0.05). The DC+, HRCC- and DC- techniques yielded significantly lower chondrocyte survival rates compared with the control method (P < 0.05).

Conclusions: Chondrocyte survival in osteochondral cylinders depends on the applied harvesting technique. The use of rotary cutters without cooling yielded worst results, while the traditional OATS punch and rotary cutters with cooling achieved comparable rates of chondrocyte vitality.

Keywords: Chondrocyte harvesting; Chondrocyte survival; Diamond cutter; Hollow reamer; OATS harvester; Osteochondral transplant.

MeSH terms

  • Animals
  • Cartilage, Articular / cytology*
  • Cell Survival
  • Chondrocytes / cytology*
  • Humans
  • Knee Joint / surgery
  • Sheep
  • Tissue and Organ Harvesting / methods*
  • Transplantation, Autologous / methods*