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The repair of osteochondral defects using an exogenous fibrin clot

An experimental study in dogs

Laboratory for Comparative Orthopaedic Research, Hospital for Special Surgery, The New York Hospital and the Cornell University Medical College, New York, New York

Steven P. Arnoczky, DVM

Laboratory for Comparative Orthopaedic Research, Hospital for Special Surgery, The New York Hospital and the Cornell University Medical College, New York, New York

Russell F. Warren, MD

Laboratory for Comparative Orthopaedic Research, Hospital for Special Surgery, The New York Hospital and the Cornell University Medical College, New York, New York

To evaluate the ability of an exogenous fibrin clot to hasten or optimize the repair of full-thickness articular cartilage defects, 4-mm diameter, full-thickness articu lar cartilage defects in 20 adult mongrel dogs were packed with an exogenous fibrin clot that had been prepared from each animal. The defects were created in a loaded and unloaded portion of the femoral troch lea. The healing response was then examined using routine histology at various intervals from 2 weeks to 6 months.

Both the experimental (clot-filled) and control (empty) defects healed through a proliferation of fibrous con nective tissue that eventually modulated into fibrocar tilage. However, in the 2-, 4-, and 8-week animals, the experimental defects (both loaded and unloaded) dem onstrated a more organized and advanced healing re sponse than did the control defects. This difference was less pronounced in the 12- and 24-week animals. In all specimens, the clot-filled defects healed more uniformly than controls with less surface depression. In general, the unloaded sites were more uniform in heal ing than the corresponding loaded sites.

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