Arthroscopic Cartilage Lesion Preparation in the Human Knee Using Standard Curette Technique: Morphologic Variations and Location-Dependent Qualitative Differences Demonstrated by Histologic Examination
Author(s):
Blasiak A. (Poland)
,
Blasiak A. (Poland)
Affiliations:
Sadlik B.
,
Sadlik B.
Affiliations:
Matlak A.
,
Matlak A.
Affiliations:
Klon W.
,
Klon W.
Affiliations:
Puszkarz M.
,
Puszkarz M.
Affiliations:
Whyte G.
Whyte G.
Affiliations:
ESSKA Academy. BLASIAK A. 05/09/18; 209316; P03-1875 Topic: Arthroscopic Surgery
Mr. Adrian BLASIAK
Mr. Adrian BLASIAK
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Abstract
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Objectives: To examine the quality of arthroscopic cartilage debridement using curette technique by comparing variations within cartilage lesions prepared in human cadaveric knee specimens. A secondary aim is to compare the properties of cartilage lesions prepared by surgeons of varying experience.

Methods: Standardized cartilage lesions (8x15mm), located to the medial/lateral condyle and medial/lateral trochlea were created within human cadaver knees by 40 orthopaedic surgeons. Histologic specimens were prepared to examine the verticality of surrounding cartilage walls at the front and rear aspects of the lesions, and to characterize the properties of surrounding cartilage, the cartilage wall profile, the debrided lesion depth, bone sinusoid access, and the bone surface profile.

Results: There was no significant association of cartilage lesion wall verticality and surgeon experience. Mean cartilage wall verticality was superior at the rear aspect of the lesion compared to the front aspect (p < 0.001). Variability was identified in the morphology of surrounding cartilage (p<0.001), cartilage wall profile (p=0.016), debrided lesion depth (p=0.028), bone sinusoid access (p=0.009), and bone surface profile (p=0.040).

Conclusions: Arthroscopic cartilage lesion preparation using standard curette technique results in inferior perpendicularity of surrounding cartilage walls at the front aspect of the defect, compared to the rear aspect. Depth of debridement is generally acceptable for the purposes of cartilage repair procedures, although there is significant variability, with debridement depths often being either too superficial or too deep to the calcified cartilage layer. Surgeon experience does not appear to impact morphologic properties of cartilage lesions prepared arthroscopically using curettes.

Keywords:
Articular Cartilage, Cartilage Repair, Knee, Arthroscopy, Histology Scoring Systems
Objectives: To examine the quality of arthroscopic cartilage debridement using curette technique by comparing variations within cartilage lesions prepared in human cadaveric knee specimens. A secondary aim is to compare the properties of cartilage lesions prepared by surgeons of varying experience.

Methods: Standardized cartilage lesions (8x15mm), located to the medial/lateral condyle and medial/lateral trochlea were created within human cadaver knees by 40 orthopaedic surgeons. Histologic specimens were prepared to examine the verticality of surrounding cartilage walls at the front and rear aspects of the lesions, and to characterize the properties of surrounding cartilage, the cartilage wall profile, the debrided lesion depth, bone sinusoid access, and the bone surface profile.

Results: There was no significant association of cartilage lesion wall verticality and surgeon experience. Mean cartilage wall verticality was superior at the rear aspect of the lesion compared to the front aspect (p < 0.001). Variability was identified in the morphology of surrounding cartilage (p<0.001), cartilage wall profile (p=0.016), debrided lesion depth (p=0.028), bone sinusoid access (p=0.009), and bone surface profile (p=0.040).

Conclusions: Arthroscopic cartilage lesion preparation using standard curette technique results in inferior perpendicularity of surrounding cartilage walls at the front aspect of the defect, compared to the rear aspect. Depth of debridement is generally acceptable for the purposes of cartilage repair procedures, although there is significant variability, with debridement depths often being either too superficial or too deep to the calcified cartilage layer. Surgeon experience does not appear to impact morphologic properties of cartilage lesions prepared arthroscopically using curettes.

Keywords:
Articular Cartilage, Cartilage Repair, Knee, Arthroscopy, Histology Scoring Systems
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