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The Journal of Bone and Joint Surgery, Vol 73, Issue 9 1301-1315, Copyright © 1991 by Journal of Bone and Joint Surgery, Inc
The potential for regeneration of articular cartilage in defects created by chondral shaving and subchondral abrasion. An experimental investigation in rabbits
HK Kim, ME Moran and RB Salter
Division of Orthopaedic Surgery, Hospital for Sick Children, University of Toronto, Ontario, Canada.
Animal models for chondral shaving and subchondral abrasion were created to
resolve the controversy about the nature of the repair tissue after these
procedures and to determine the effect of continuous passive motion on the
quality of the repair tissue. Chondral shaving was performed on the patella
in forty adolescent rabbits, and subchondral abrasion was performed on the
patella in another forty rabbits. In both procedures, a
three-millimeter-diameter defect was created. After the operation, twenty
animals from each group were allowed intermittent active motion; the
remainder were treated by continuous passive motion for two weeks, followed
by intermittent active motion. Half of the animals from each group were
killed at four weeks and the other half, at twelve weeks. There was no
evidence of repair tissue in the defects at either four or twelve weeks
after chondral shaving, regardless of the postoperative treatment. The
remaining underlying cartilage, however, had degenerated. After abrasion of
subchondral bone, the defects in animals that were treated with only
intermittent active motion healed at twelve weeks, although the quality of
the repair tissue varied. All ten of the animals that were treated with
continuous passive motion, however, had mature, hyaline-like cartilage as
the predominant repair tissue at twelve weeks, compared with six of the ten
animals that were treated with intermittent active motion (p less than
0.05). We concluded that, in this model, partial-thickness defects created
by chondral shaving do not heal; rather, the remaining underlying cartilage
degenerates. Full-thickness defects created by subchondral abrasion can
heal by regeneration of hyaline-like cartilage. Such healing is enhanced by
continuous passive motion for two weeks postoperatively.
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