Treatment of chondral lesions in advanced osteochondritis dissecans: a comparative study of the efficacy of chondrocytes, mesenchymal stem cells, periosteal graft, and mosaicplasty (osteochondral autograft) in animal models.

Abstract

Management of chondral lesions in osteochondritis dissecans remains a challenge. This study investigated the efficacy of periosteal graft, osteochondroidal autograft, autologous chondrocyte and mesenchymal stem cell transplants in the treatment of chondral lesions in animal models. Full-thickness articular cartilage defects were created in the weight-bearing surface of the medial femoral condyle in 20-week-old NZW rabbits. A total of 56 knees were randomly divided into four groups as follows: group 1, transfer of cultured chondrocytes; group 2, transfer of cultured mesenchymal stem cells; group 3, repair by periosteal graft; and group 4, mosaicplasty. All of the contralateral knees served as control. Gross, histologic, and biomechanical examinations at 36 weeks after the operation showed that the cultured chondrocytes and mesenchymal stem cells had comparable enhancing effects on the repair of chondral defects in advanced osteochondritis dissecans, whereas mosaicplasty did well initially and periosteal graft did less favorably.