Purpose

To (1) validate a harvesting technique using arthroscopic shaver to collect articular cartilage from the femoral head and to (2) compare the chondron yield and chondron viability to a manual mincing method and a device assisted mincing procedure.

Methods and Materials

Femoral heads were collected from patients with avascular necrosis of the femoral head who underwent total hip arthroplasty (THA) and processed in the laboratory. A 4.0 mm arthroscopic shaver with an attached chondral fragment capture device (GraftNet) was used to harvest the chondral surface from the area of the non-weight bearing regions of the femoral head. The cells were filtered and chondrocytes were isolated by enzymatic digestion. Cells were counted and stained with a live-dead stain and Safranin-O.

Results

16 cartilage samples were processed in total. 12 samples underwent manual processing (surgical removal of cartilage from bone by scalpel, manual mincing with scalpel or mincing device) and 4 samples were retrieved with a 4.0 mm arthroscopic shaver. The different methods produced cartilage particulate of significantly different sizes. Manual mincing with a scalpel or mincing device resulted in larger particles than shaver harvest. Cell yield and viability were comparable between the groups.

Figure 1. Chondron cluster with typical nuclei and extracellular matrix in an arthroscopic shaver sample

Figure 2. 4 chondrons in an arthroscopic shaver sample

Conclusion

The proposed harvesting method produces a high cell yield and good cell viability with a limited amount of debris. Future studies are needed to focus on short- and long-term outcomes of clinical application, as well as safety and efficacy, and to compare the results with other cartilage restoration and harvesting procedures of the hip.