Background: Previous literature shows that current osteochondral allograft (OCA) harvesting techniques lead to donor plug chondrocyte death during OCA transplant for treating focal knee cartilage defects. Purpose: To evaluate the effects of drilling/reaming speed and irrigation temperature on chondrocyte viability during OCA harvest. Study Design: Controlled laboratory study. Methods: From each human femoral condyle (n = 9) used in the study, cartilage plugs were harvested using a powered reamer with 15 mm–diameter coring bit and continuous saline irrigation. Four experimental groups were formed according to the following parameters that were used to randomly harvest the plugs: (1) drill speed setting with room temperature (RT) saline; (2) ream speed setting with RT saline; (3) drill speed setting with cold saline; (4) ream speed setting with cold saline. A control cartilage sample was harvested with a scalpel from a macroscopically healthy region near the intercondylar notch in each specimen. Chondrocyte viability, determined by calcein and ethidium live/dead stain, was compared between groups and controls across the whole, central third, and peripheral thirds of cartilage samples. Results: Whole drill RT ( P = .001) and whole ream RT ( P = .004) viabilities were significantly decreased in experimental samples compared with controls. Viability at the center and periphery of drill RT plugs ( P = .001 and P < .001, respectively) and ream RT plugs ( P = .001 and P = .002, respectively) were also decreased. Conversely, viability was not significantly different between controls and either whole drill cold ( P = .17), center drill cold ( P = .24), periphery drill cold ( P = .20), whole ream cold ( P = .15), center ream cold ( P = .24), or periphery ream cold ( P = .07) samples. Viability was decreased in whole drill RT compared with whole ream RT ( P = .015), but there was no difference between whole drill cold and whole ream cold ( P = .26). Conclusion: Continuous irrigation with 5°C saline rather than RT saline during OCA harvest maintained donor graft chondrocyte viability in vitro. With RT irrigation, faster reamer speed induced more chondrocyte death than slower reamer speed, although this difference was mitigated with 5°C saline irrigation. Clinical Relevance: Irrigation with 5°C saline during donor plug OCA harvest may mitigate thermally induced chondrocyte damage and improve graft incorporation, healing, and outcomes of OCA transplant.

中文翻译：

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同种异体骨软骨移植物软骨细胞活力在收获过程中受灌溉温度和铰刀速度的影响


背景： 以前的文献表明，目前的同种异体骨软骨移植物 （OCA） 采集技术导致 OCA 移植期间供体塞软骨细胞死亡，用于治疗局灶性膝软骨缺损。目的：评估 OCA 收获期间钻孔/扩孔速度和冲洗温度对软骨细胞活力的影响。研究设计： 对照实验室研究。方法：从研究中使用的每个人股骨髁 （n = 9） 中，使用带有 15 mm 直径取芯钻头的电动铰刀和连续盐水冲洗收获软骨栓。根据以下参数组成四个实验组，用于随机收获塞子：（1） 用室温 （RT） 盐水设置钻孔速度;（2） 用 RT 盐水设置扩孔速度;（3） 用冷盐水设定钻孔速度;（4） 用冷盐水进行扩速设置。用手术刀从每个标本中髁间切迹附近的宏观健康区域收获对照软骨样本。通过钙黄绿素和乙锭活/死染色测定的软骨细胞活力，在各组和对照组之间比较整个、中央三分之一和外周三分之一软骨样本的活力。结果： 与对照相比，实验样品中的全钻 RT （P = .001） 和整令 RT （P = .004） 活力显著降低。钻头 RT 塞 （分别为 P = .001 和 P < .001） 和铰 RT 塞 （分别为 P = .001 和 P = .002） 的中心和外围的活力也降低。 相反，对照与整个钻头冷 （P = .17）、中心钻头冷 （P = .24）、外围钻头冷 （P = .20）、整令冷 （P = .15）、中心冷 （P = .24） 或外围冷 （P = .07） 样品之间的活力没有显著差异。与整令 RT 相比，全钻 RT 的活力降低 （P = .015），但全钻冷和整令冷之间没有差异 （P = .26）。结论： 在 OCA 收获期间用 5°C 盐水而不是 RT 盐水连续冲洗可维持供体移植物软骨细胞的体外活力。使用 RT 冲洗时，较快的扩孔器速度比较慢的扩孔器速度诱导更多的软骨细胞死亡，尽管这种差异通过 5°C 盐水冲洗得到缓解。临床相关性： 在供体栓 OCA 收获期间用 5°C 生理盐水冲洗可以减轻热诱导的软骨细胞损伤并改善移植物的掺入、愈合和 OCA 移植的结果。