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Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_II | Pages 100 - 100
1 May 2011
Vaisman A Figueroa D Melean P Calvo R Espinoza M Scheu M
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Introduction: The results of treating chondral lesions with microfracture have been well documented. The lesion heals by fibrocartilage and the functional results tend to deteriorate through time.

Hypothesis: The use of steroids an platelet rich plasma (PRP) as coadjuvants to microfracture for the treatment of full thickness chondral lesions improve the results of this marrow stimulating technique.

Purpose: To macroscopically, histologically and molecularly evaluate the repair tissue generated after treating full thickness chondral lesions with microfracture and local steroids or PRP in an animal model.

Materials: Experimental in-vivo study in 40 femoral condyles (FC) from New Zealand rabbits. Chondral lesions were induced in all the samples and divided into 4 groups:

Group 1: control, lesion left untreated.

Group 2: microfracture.

Group 3: microfracture + intraarticular betamethasone.

Group 4: microfracture + PRP.

Animals were sacrificed after 3 months and the samples were evaluated macroscopically, histologically (H and E, Toluidine Blue) and molecularly (RT-PCR for Col1 and Col2). The results were analyzed with ANOVA and Bonferroni tests (p< 0.05).

Results: Macroscopy: the control group had no healing tissue. In all the other groups there was a variable presence of a fibrocartilaginous tissue without significant differences among groups.

Histology: all the groups had the presence of fibrocartilage.

Molecular analysis: all the groups had a significantly poorer Col2/Col1 relation when compared to normal hyaline cartilage, without significant difference among groups.

Conclusions: The local use of betamethasone and PRP as coadjuvants to microfracture does not improve the macroscopical, histological and molecular results of the treatment of full thickness chondral lesions.


Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_II | Pages 116 - 116
1 May 2011
Vaisman A Melean P Figueroa D Figueroa F Calvo R Villalon I
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Introduction: Bunnell suture technique is effective for tendon repair. A modification of the classic suture technique could increase ultimate failure point (UFP) on the suture-tendon site. The purpose of this study is to evaluate UFP of regular and modified Bunnell suture techniques on in vitro porcine patellar tendons.

Methods: Porcine patellar tendon samples (N=24) were used for this study, separating them in 2 groups: Group A: classic Bunnell suture on the tendon (N=12). Group B: two perpendicular Bunnell sutures at 90° between them on the tendon (N=12). After suturing the samples, axial traction until failure on the tendon-suture site was applied on samples of both groups documenting UFP with a tension sensor device. UFP was measured and described in Newtons for all samples. Statistics: Non parametric Mann-Whitney test for independent variables was used to analyze outcomes.

Results: The UFP for group A was 224 ± 38,9 N. The UFP for group B was 307 ± 19,9 N. We found statistical differences among groups (p=0,00006).

Discussion: In this study we analyzed the UFP of classic Bunnell suture technique vs. a modification adding a second Bunnell suture perpendicular to the classic technique. The purpose of this modification is to increase the contact area between the suture and the tendon, reaching a stronger disposition at suture-tendon site. This has been documented in the UFP values obtained.

Conclusion: Adding a perpendicular Bunnell suture run in porcine ex vivo patellar tendons increases UFP in tendon repair at tendon – suture site.