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Split-line pattern and histologic analysis of a human osteochondral plug graft
Brian M Leo1, Maria A Turner, David R Diduch
1Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia, USA.
Summary
Osteochondral plug transfer can succeed even with minor collagen misalignment. Proper patient selection for focal traumatic defects is crucial for successful cartilage repair outcomes.
Area of Science:
- Orthopedic surgery
- Biomedical engineering
- Cartilage repair
Background:
- Articular cartilage collagen fibers align with weight-bearing stresses.
- The clinical significance of aligning osteochondral plug grafts with surrounding cartilage remains unevaluated.
Observation:
- A case report analyzed an osteochondral plug transfer site converted to total knee arthroplasty.
- Split-line patterns were visualized using India ink, and histology confirmed collagen orientation.
Findings:
- The graft's anterior portion aligned with native cartilage, but the posterior portion showed ~30° divergence.
- Articular degeneration occurred at the divergent margin, despite graft survival and bony incorporation.
- A chondral cleft persisted at the graft-host interface.
Implications:
- Osteochondral plug grafts can survive with slight collagen divergence.
- Selecting focal traumatic lesions over degenerative ones may be key for successful osteochondral grafting.
- This highlights the importance of precise graft alignment in cartilage restoration procedures.