Podium Presentation Allografts

16.3.1 - Anatomic Factors Associated With Osteochondral Allograft Matching For Trochlear Cartilage Defects

Presentation Topic
Allografts
Date
14.04.2022
Lecture Time
11:24 - 11:33
Room
Potsdam 1
Session Name
Session Type
Free Papers
Speaker
  • A. Yanke (Chicago, US)
Authors
  • A. Yanke (Chicago, US)
  • N. Dandu (Chicago, US)
  • N. Horner (Chicago, US)
  • N. Trasolini (Chicago, US)
  • W. Cregar (Chicago, US)
  • H. Huddleston (Chicago, US)
  • N. Inoue (Chicago, US)
Disclosure
Navya Dandu Nolan S. Horner Nicholas A Trasolini DJ Orthopaedics William Cregar Hailey P. Huddleston Nozomu Inoue MD National Institutes of Health (NCCIH) Adam Yanke AlloSource Arthrex CONMED Linvatec JRF Olympus Organogenesis PatientIQ Smith & Nephew S

Abstract

Purpose

To evaluate anatomic factors of donor and recipient trochleae associated with osteochondral allograft matching for superolateral and central defects in a computer-simulated model.

Methods and Materials

Ten cadaveric trochlear specimens were utilized for this study. Three-dimensional (3D) point cloud models of the trochleae were created using a segmentation software program from CT scans (Mimics, Materialise Inc., Leuven, Belgium). Circular defect models were created virtually at both superolateral (18mm and 22.5mm) and central (18mm, 22.5mm, 30mm) locations. The mean articular step-off was calculated along the periphery of the graft. Demographic and anatomic factors measured include age, sex, laterality, lateral facet width, medial facet width, lateral condyle radius of curvature, trochlear groove radius of curvature, tibial width, trochlear length, and trochlear width. Sulcus angle and sagittal angle at the center of the defect and grafts for the central trochlear location were calculated by a custom-designed program.

Results

On multivariate analysis, sulcus angle difference (β=0.019, p=0.002), sagittal angle difference (β=0.018, p=0.001), and lateral condyle radius of curvature (β=0.015, p=0.003) were significant predictors of articular step-off for 18mm central defects (R2=0.45). For 22.5mm central defects, sulcus angle difference (β=0.029, p<0.001), sagittal angle difference (β=0.025, p<.001), medial facet width (β=0.026, p=0.021), and lateral radius of curvature (β=0.013, p=0.025) were significant. Similarly, for 30mm central defects, sulcus angle difference (β=0.03, p=0.001), lateral radius of curvature (β=.032, p=0.004), and trochlear length (β=0.041, p<0.001), were significant predictors. For 18mm superolateral defects, no significant predictors were identified on multivariate analysis. For 22.5mm superolateral trochlear defects, medial facet width (β=.006, p<0.001) and trochlear length (β=.002, p=0.003) were significantly associated.

Conclusion

Minimizing mismatch in anatomic factors such as sulcus angle, sagittal angle, lateral condyle radius of curvature, and medial facet width may contribute to more optimal graft matching.figure 1.jpg

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