Abstract 2

Treatment methods for focal chondral defects of the knee-clinical and histologic evaluation

Minna Rong, Craig Willers, John Hart*, Jiake Xu and MingHao Zheng

Molecular Orthopaedic Labortory, Orthopaedics Unit, School of Pathology and Surgery, University of Western Australia, Nedlands WA 6009, Australia.

* Department of Surgery, Monash University Alfred Hospital, Melbourne, Pranhran. Victoria 3181, Australia.

Various treatment techniques have been developed in recent decades to stimulate the repair of injured articular cartilage. Carbon fibre implantation (CFI), microfracture (MFX), and autologous chondrocyte implantation (ACI) are some techniques for the treatment of chondral defects in the knee. Despite the abundance of studies has been conducted into these individual therapies, there has been no studies that compared these various treatments. We have performed a retrospective single-surgeon study to analyse the histological and functional results of current articular cartilage repair techniques. Twenty-six patients who underwent different cartilage repair procedures of the knee (16 ACI, 5 MFX and 9 CFI) were biopsied at least one year postoperatively. Standard staining (H&E) was used to examine the sections for cellular morphology of repair tissue type. Additionally, immunohistochemistry was used to determine type-I, type-II, type-X collagen, and S-100 expression, and in situ hybridizaition evaluated Sox-9 and aggrecan mRNA expression. Qualitative improvement on the histology and gene expression occurs with ACI (P=0.001) and MFX (P=0.007) over carbon fibre implantation, however there was no significant difference between ACI and MFX (P>0.05). Additionally, the histology and gene expression outcomes of the three different techniques positively correlated to functional outcomes. This study suggests that ACI and MFX have similar clinical efficacies, whereas CFI may be less indicated for chondral repair of the knee.

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