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The Journal of Bone and Joint Surgery, Vol 66, Issue 8 1248-1257, Copyright © 1984 by Journal of Bone and Joint Surgery, Inc
The induction of neochondrogenesis in free intra-articular periosteal autografts under the influence of continuous passive motion. An experimental investigation in the rabbit
SW O'Driscoll and RB Salter
The purpose of this study was to determine the chondrogenic potential of
free intra-articular autografts of periosteum under the influence of joint
immobilization compared with continuous passive motion. A graft of
periosteum (including the cambium layer) was taken from the medial aspect
of the proximal end of the tibia and transplanted into each corresponding
knee joint in thirty adolescent New Zealand rabbits. A cast was applied to
the left hind limb to immobilize the knee joint in a position of 40 degrees
of flexion; the animal was then placed on the continuous passive-motion
apparatus so that the right knee joint could be moved continuously and
passively from 40 to 110 degrees of flexion. Fifteen rabbits were killed at
intervals from seven to twenty-eight days and fifteen rabbits were killed
at twenty-one days. The grafts in the immobilized limbs were small and
soft, and did not resemble cartilage, whereas the grafts in the limbs that
had been treated with continuous passive motion had grown much larger and
had taken on the gross appearance of articular cartilage. After one week
the cells in the cambium layer were rapidly proliferating and by two weeks
there was consistent evidence of differentiation along a chondroid line in
the grafts that had been exposed to continuous passive motion. After three
weeks bone formation was apparent in all of the grafts, which had become
adherent to the synovial tissue and vascularized. Cartilage was the
predominant tissue in only 8 per cent of the grafts in the immobilized
limbs, compared with 59 per cent of the grafts (p less than 0.01) in the
limbs exposed to continuous passive motion. This investigation demonstrated
the chondrogenic potential of free periosteal grafts in a synovial fluid
environment and also the stimulating effect of continuous passive motion on
periosteal neochondrogenesis.
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