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Histological and Inflammatory Cytokine Analysis of Osteochondral Lesions of the Talus After Failed Microfracture: Comparison With Fresh Allograft Controls.

Publication ,  Journal Article
Danilkowicz, RM; Allen, NB; Grimm, N; Nettles, DL; Nunley, JA; Easley, ME; Adams, SB
Published in: Orthop J Sports Med
October 2021

BACKGROUND: The most common first-line treatment of osteochondral lesions of the talus (OLTs) is microfracture. Although many patients do well with this procedure, a number fail and require reoperation. The mechanism of failure of microfracture is unknown, and to our knowledge there has been no research characterizing failed microfracture regarding histological and inflammatory makeup of these lesions that may contribute to failure. PURPOSE: To characterize the structural and biochemical makeup of failed microfracture lesions. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Specimens from 8 consecutive patients with symptomatic OLTs after microfracture who later underwent fresh osteochondral allograft transplantation were analyzed. For each patient, the failed microfracture specimen and a portion of the fresh allograft replacement tissue were collected. The allograft served as a control. Histology of the failed microfracture and the allograft replacement was scored using the Osteoarthritis Research Society International (OARSI) system. Surface roughness was also compared. In addition, tissue culture supernatants were analyzed for 16 secreted cytokines and matrix metalloproteinases (MMPs) responsible for inflammation, pain, cartilage damage, and chondrocyte death. RESULTS: The OARSI grade, stage, and total score as well as surface smoothness were significantly worse in the failed microfracture sample, indicating better cartilage and bone morphology for the allografts compared with the failed microfracture lesions. Analyzed cytokines and MMPs were significantly elevated in the microfracture tissue culture supernatants when compared with fresh osteochondral tissue supernatants. CONCLUSION: These data demonstrate a significantly rougher cartilage surface, cartilage and subchondral bone histology that more closely resembles osteoarthritis, and elevated inflammatory cytokines and MMPs responsible for pain, inflammation, cartilage damage, and chondrocyte death when compared with fresh osteochondral allografts used as controls.

Duke Scholars

Published In

Orthop J Sports Med

DOI

ISSN

2325-9671

Publication Date

October 2021

Volume

9

Issue

10

Start / End Page

23259671211040535

Location

United States

Related Subject Headings

  • 4207 Sports science and exercise
  • 3202 Clinical sciences
  • 1106 Human Movement and Sports Sciences
  • 1103 Clinical Sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Danilkowicz, R. M., Allen, N. B., Grimm, N., Nettles, D. L., Nunley, J. A., Easley, M. E., & Adams, S. B. (2021). Histological and Inflammatory Cytokine Analysis of Osteochondral Lesions of the Talus After Failed Microfracture: Comparison With Fresh Allograft Controls. Orthop J Sports Med, 9(10), 23259671211040536. https://doi.org/10.1177/23259671211040535
Danilkowicz, Richard M., Nicholas B. Allen, Nate Grimm, Dana L. Nettles, James A. Nunley, Mark E. Easley, and Samuel B. Adams. “Histological and Inflammatory Cytokine Analysis of Osteochondral Lesions of the Talus After Failed Microfracture: Comparison With Fresh Allograft Controls.Orthop J Sports Med 9, no. 10 (October 2021): 23259671211040536. https://doi.org/10.1177/23259671211040535.
Danilkowicz RM, Allen NB, Grimm N, Nettles DL, Nunley JA, Easley ME, et al. Histological and Inflammatory Cytokine Analysis of Osteochondral Lesions of the Talus After Failed Microfracture: Comparison With Fresh Allograft Controls. Orthop J Sports Med. 2021 Oct;9(10):23259671211040536.
Danilkowicz, Richard M., et al. “Histological and Inflammatory Cytokine Analysis of Osteochondral Lesions of the Talus After Failed Microfracture: Comparison With Fresh Allograft Controls.Orthop J Sports Med, vol. 9, no. 10, Oct. 2021, p. 23259671211040536. Pubmed, doi:10.1177/23259671211040535.
Danilkowicz RM, Allen NB, Grimm N, Nettles DL, Nunley JA, Easley ME, Adams SB. Histological and Inflammatory Cytokine Analysis of Osteochondral Lesions of the Talus After Failed Microfracture: Comparison With Fresh Allograft Controls. Orthop J Sports Med. 2021 Oct;9(10):23259671211040536.
Journal cover image

Published In

Orthop J Sports Med

DOI

ISSN

2325-9671

Publication Date

October 2021

Volume

9

Issue

10

Start / End Page

23259671211040535

Location

United States

Related Subject Headings

  • 4207 Sports science and exercise
  • 3202 Clinical sciences
  • 1106 Human Movement and Sports Sciences
  • 1103 Clinical Sciences