Details

Autor(en) / Beteiligte

• Kordas, Geza

Titel

Oszteokondrális graftok primer stabilitása mozaikplasztika után

Ort / Verlag

ProQuest Dissertations & Theses

Erscheinungsjahr

2007

Link zum Volltext

• ProQuest

Quelle

ProQuest Dissertations & Theses A&I

Beschreibungen/Notizen

• Focal chondropathies of weight-bearing joints may result in osteoarthritis in the long term. One of the many treatment methods for this condition is mosaicplasty. This technique involves transplantation of osteochondral grafts from the less weight-bearing areas of the knee into the defect. It is paramount for the success of the technique that grafts form a congruent surface and this congruency is maintained until bony union occurs. Primary stability of the grafts is secured by the press-fit mechanism between the bone plug and the recipient hole. It is not know to date if this press-fit stability strong enough to commence immediate full weight-bearing postoperatively. Improved primary stability would allow more vigorous physiotherapy and shorten or eliminate the non weight-bearing period. Primary stability is determined by graft diameter, dilation length, graft- and drill hole length and multiple grafting. The aim of our studies was to quantify the effect of these parameters on primary stability after mosaicplasty. Mosaicplasty was performed on porcine distal femurs and push-in forces were measured. Our result showed that 6.5 mm grafts resist 1.3 times more compressive force than 4.5 mm grafts and dilation length of 15 vs. 20 mm resulted in significant difference at 3 mm below cartilage level only. Drill hole length has major impact on primary stability. 15 mm grafts inserted into 12 mm drill holes resulted in significantly higher level push-in forces, while matched graft and drill hole length provided better primary stability without increased push-in forces. Multiple grafting resulted in decreased primary stability compared to single grafting. Based on our results we recommend the use of relatively smaller diameter grafts, matched graft and drill-hole length especially in multiple grafting. The values for push-in forces in our experiment were close to the physiological stresses in the knee therefore if better primary stability can be achieved by improved operative technique reliably, full weight-bearing after mosaicplasty could be allowed in the future.