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KMID : 0350519920450030933
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Journal of Catholic Medical College
1992 Volume.45 No. 3 p.933 ~ p.944
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Replantation of Cryopreserved Osteochondral Allograft Using Liquid Nitrogen in Rabbit Joint Defect
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Abstract
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Autologous bone has been long accepted as the ideal graft. However, donor site morbidity and the frequent lack of sufficient available bone for specific clinical needs provide an urgent incentive to search for an alternative suitable graft
material.
Allogenic bone has gained widespread acceptance over the past several decades for grafting large bony defects and for the patients whose ability to tolerate the second harvesting operation is unstable. Although the fresh allograft is highly
antigenic,
the preponderance of evidence suggests that freezing at tempertures of -70℃or colder decreases allograft antigenicity. But the fate of osteochondral allograft which was frozen with liquid nitrogen(-196℃) has not been established.
The purpose of this experiment is to evaluate the viability of osteochondral allograft which was frozen with liquid nitrogen when replanted. Large bone defect has been made at the distal femur including joint surface using twenty adult rabbits
and
simultaneously the joint was replaced by osteochondral allograft which was frozen for 10 min. with liquid nitrogen. The replanted frozen osteochondral allografts were radiologically and histologically observed regularly at 4, 8, 16 and 24 weeks
after
the replantation.
@ES The results were as follows:
@EN 1. Four weeks after replantation simple roentgenographic findings began to show the sclerotic change of the osteochondral allograft. After 16 weeks, the sclerotic change was decreased and evidence of union of osteochondral allograft was seen
in
all
cases. Pathologic fracture did not occur in any case.
2. Gross findings showed that the cartilage surface was partially destroyed at fourth week after replantation. On the other hand, some part of the articular cartilage was preserved even after 24 weeks.
3. In microscopic finding, some part of cartilage was destroyed four weeks after replantation, and the cartilage cell destruction was continued during the observation period. After 24 weeks, there was a wide range of cartilage cell destruction
at
the
articulating area. Nevertheless, some cartilage cells were alive at the osteochondral junction.
4. After deep freezing with liquid nitrogen, the allograft bone was destroyed completely. Then, replacement of the dead bone was obtained by "creeping substitution" where osteoblasts from nomal bone produced new bone while osteoclasts cleared
the
dead
bone. This process started at fourth week and continued until 24 weeks of observation.
During the whole 24 weeks of observation, the dead bone had been almost completely replaced by new bone.
Through this study, the authors were able to prove the fact that the massive osteochondral. Allograft which was frozen with liquid nitrogen can be used for the replacement of comparable anatomical deficits resulting from trauma, degenerative
disease and
most notably, neoplastic diseases for which limb-sparing techniques appear rewarding.
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KEYWORD
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