Maturation-dependent durability of spontaneous cartilage repair in rabbit knee joint

The spontaneous healing of osteochondral defects in the knee joints of immature rabbits within the first 12 weeks after surgery showed a faster filling and earlier tissue specialization than in adult animals. The purpose of the present study was to investigate whether the better short-term quality of spontaneous repairs in immature animals lasted over a period of 48 weeks. A full-thickness osteochondral defect was created on the medial femoral condyle in both knees of 10 young, 10 adolescent, and 10 adult rabbits. Equal numbers of animals were evaluated after 24 and 48 weeks. At both time intervals, bonding to adjacent cartilage and proteoglycan content of the matrix were better in the repairs of young than in adult animals. Repairs in the former had cellularity similar to the adjacent cartilage and were composed of 90% hyaline-like cartilage, which did not decrease with time. In contrast, repairs in older animals formed less hyaline-like cartilage and had a lower cellularity than the adjacent cartilage. However, the surface of the repaired tissue was similarly disrupted in all age groups, and the mechanical properties remained inferior to adjacent or normal cartilage. Repairs in older animals showed signs of degeneration with time. The initial better repair quality in a young, growing animal remained up to 48 weeks when the animal had already reached maturity, indicating that successful initial promotion of cartilage repair may even lead to better results in the long term. However, it has to be pointed out that the morphologically good repairs with hyaline-like cartilage appearance, normal cellularity, and durability of up to 48 weeks were unable to reestablish and maintain a cartilage-like mechanical function.