Scientific Article   |    
Surgical Removal of Articular Cartilage Leads to Loss of Chondrocytes from Cartilage Bordering the Wound Edge
Ernst B. Hunziker, MD; Thomas M. Quinn, PhD
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Corresponding author: Ernst B. Hunziker, MD
ITI Research Institute, University of Bern, Murtenstrasse 35, P.O. Box 54, CH-3010 Bern, Switzerland. E-mail addressvt: ernst.hunziker@iti.unibe.ch

In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from Orthogene LLC, Greenbrae, California, and T.M. Quinn received a fellowship from the Arthritis Society of Canada. None of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. A commercial entity (University of Bern) paid or directed, or agreed to pay or direct, benefits to a research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

J Bone Joint Surg Am, 2003 Apr 01;85(suppl 2):85-92
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Background: A number of arthroscopic procedures that are used in the treatment of focal cartilage lesions or osteoarthritic joints, such as shaving, débridement, and laser abrasion, involve the removal of both diseased and healthy articular cartilage. The excision of such tissue has the effect of generating lesions within the articular cartilage. The fate of the chondrocytes that border such lesions has not been evaluated. The purpose of this investigation was to ascertain whether the surgical creation of lesions in articular cartilage induces irreversible loss of chondrocytes over time from tissue bordering the wound edge and to determine whether the synthetic activity of cells in this region is compromised.

Methods: Partial-thickness defects of defined dimensions were created in the femoral condyle and/or trochlear groove of rabbits and miniature pigs. Cell volumes, cell volume densities, and numerical cell densities within tissue close to (within 100 µm) and remote from (control site) the wound edge were determined by quantitative histomorphometry at various time intervals up to six months after surgery. Rates of proteoglycan synthesis by cells in both regions were determined by quantitative autoradiography following 35 S-sulphate labeling in vivo .

Results: The surgical creation of partial-thickness lesions in articular cartilage induced a significant and long-term loss of cells from tissue near the wound edge. However, the surviving cell population maintained a normal rate of matrix proteoglycan deposition.

Conclusions: This study illustrates that maintenance and remodeling of cartilage matrix close to wound edges in articular cartilage lesions is compromised, since fewer cells, with an unchanged metabolic activity rate, are left to sustain matrix domains.

Clinical Relevance: The long-term benefits of arthroscopic treatments such as shaving, débridement, and laser abrasion may be deleteriously affected by their adverse biological effects on the cells and matrix of articular cartilage.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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