Hexagonal grafts in mosaicplasty: Biomechanical comparison of standard cylindrical and novel hexagonal grafts in calf cadaver model

Objective: Cylindrical grafts are currently used to cover defected area in mosaicplasty. However, there are some difficulties with cylindrical grafts, such as potential dead space between grafts and insufficient coverage. Hexagonal graft (honeycomb model) was created and evaluated in this biomechani...

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Main Authors: Adem Kar, Nihat Demirhan Demirkıran, Hasan Tatari, Bora Uzun, Fatih Ertem
Format: Article
Language:English
Published: AVES 2017-03-01
Series:Acta Orthopaedica et Traumatologica Turcica
Online Access:http://www.sciencedirect.com/science/article/pii/S1017995X17300925
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author Adem Kar
Nihat Demirhan Demirkıran
Hasan Tatari
Bora Uzun
Fatih Ertem
author_facet Adem Kar
Nihat Demirhan Demirkıran
Hasan Tatari
Bora Uzun
Fatih Ertem
author_sort Adem Kar
collection DOAJ
description Objective: Cylindrical grafts are currently used to cover defected area in mosaicplasty. However, there are some difficulties with cylindrical grafts, such as potential dead space between grafts and insufficient coverage. Hexagonal graft (honeycomb model) was created and evaluated in this biomechanical study. Hypothesis was that harvesting grafts with hexagonal shape, which has the best volume geometry characteristics in nature, would be biomechanically advantageous and provide superior pull-out strength. Methods: Total of 24 fresh calf femurs were divided into 3 equal groups. In the first group, 1 cylindrical and 1 hexagonal graft were compared. Second group consisted of 3 cylindrical and 3 hexagonal grafts. Third group was designed to evaluate effect of graft depth; hexagonal graft implanted at 5 mm depth was compared with 20-mm-deep hexagonal graft. All specimens were subjected to pull-out test. Friction field and graft surface area were also evaluated. Results: Pull-out strength comparison of 15-mm-deep triple cylindrical grafts and 15-mm-deep triple hexagonal grafts in second group revealed statistically significant difference in favor of hexagonal grafts (p < 0.05). Surface area of cylindrical graft with 9-mm diameter was calculated to be 50.27 mm2, while hexagonal graft surface area was 55.425 mm2. Volume ratio of cylindrical and hexagonal grafts was 753.98 mm3 and 831.375 mm3, respectively. Conclusion: This biomechanical study demonstrated that graft geometry, especially in multiple graft applications, is a factor that influences stability. Hexagonal grafts appear to be more stable than cylindrical grafts in multiple applications, and they may be used to cover a larger defected area. Keywords: Cartilage defect, Hexagonal graft, Knee, Mosaicplasty
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spelling doaj.art-aa5eb6367dfb4e62bb4fae5effc102202023-02-15T16:14:15ZengAVESActa Orthopaedica et Traumatologica Turcica1017-995X2017-03-01512160164Hexagonal grafts in mosaicplasty: Biomechanical comparison of standard cylindrical and novel hexagonal grafts in calf cadaver modelAdem Kar0Nihat Demirhan Demirkıran1Hasan Tatari2Bora Uzun3Fatih Ertem4Dokuz Eylül University Hospital, Izmir, TurkeyCorresponding author.; Dokuz Eylül University Hospital, Izmir, TurkeyDokuz Eylül University Hospital, Izmir, TurkeyDokuz Eylül University Hospital, Izmir, TurkeyDokuz Eylül University Hospital, Izmir, TurkeyObjective: Cylindrical grafts are currently used to cover defected area in mosaicplasty. However, there are some difficulties with cylindrical grafts, such as potential dead space between grafts and insufficient coverage. Hexagonal graft (honeycomb model) was created and evaluated in this biomechanical study. Hypothesis was that harvesting grafts with hexagonal shape, which has the best volume geometry characteristics in nature, would be biomechanically advantageous and provide superior pull-out strength. Methods: Total of 24 fresh calf femurs were divided into 3 equal groups. In the first group, 1 cylindrical and 1 hexagonal graft were compared. Second group consisted of 3 cylindrical and 3 hexagonal grafts. Third group was designed to evaluate effect of graft depth; hexagonal graft implanted at 5 mm depth was compared with 20-mm-deep hexagonal graft. All specimens were subjected to pull-out test. Friction field and graft surface area were also evaluated. Results: Pull-out strength comparison of 15-mm-deep triple cylindrical grafts and 15-mm-deep triple hexagonal grafts in second group revealed statistically significant difference in favor of hexagonal grafts (p < 0.05). Surface area of cylindrical graft with 9-mm diameter was calculated to be 50.27 mm2, while hexagonal graft surface area was 55.425 mm2. Volume ratio of cylindrical and hexagonal grafts was 753.98 mm3 and 831.375 mm3, respectively. Conclusion: This biomechanical study demonstrated that graft geometry, especially in multiple graft applications, is a factor that influences stability. Hexagonal grafts appear to be more stable than cylindrical grafts in multiple applications, and they may be used to cover a larger defected area. Keywords: Cartilage defect, Hexagonal graft, Knee, Mosaicplastyhttp://www.sciencedirect.com/science/article/pii/S1017995X17300925
spellingShingle Adem Kar
Nihat Demirhan Demirkıran
Hasan Tatari
Bora Uzun
Fatih Ertem
Hexagonal grafts in mosaicplasty: Biomechanical comparison of standard cylindrical and novel hexagonal grafts in calf cadaver model
Acta Orthopaedica et Traumatologica Turcica
title Hexagonal grafts in mosaicplasty: Biomechanical comparison of standard cylindrical and novel hexagonal grafts in calf cadaver model
title_full Hexagonal grafts in mosaicplasty: Biomechanical comparison of standard cylindrical and novel hexagonal grafts in calf cadaver model
title_fullStr Hexagonal grafts in mosaicplasty: Biomechanical comparison of standard cylindrical and novel hexagonal grafts in calf cadaver model
title_full_unstemmed Hexagonal grafts in mosaicplasty: Biomechanical comparison of standard cylindrical and novel hexagonal grafts in calf cadaver model
title_short Hexagonal grafts in mosaicplasty: Biomechanical comparison of standard cylindrical and novel hexagonal grafts in calf cadaver model
title_sort hexagonal grafts in mosaicplasty biomechanical comparison of standard cylindrical and novel hexagonal grafts in calf cadaver model
url http://www.sciencedirect.com/science/article/pii/S1017995X17300925
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AT hasantatari hexagonalgraftsinmosaicplastybiomechanicalcomparisonofstandardcylindricalandnovelhexagonalgraftsincalfcadavermodel
AT borauzun hexagonalgraftsinmosaicplastybiomechanicalcomparisonofstandardcylindricalandnovelhexagonalgraftsincalfcadavermodel
AT fatihertem hexagonalgraftsinmosaicplastybiomechanicalcomparisonofstandardcylindricalandnovelhexagonalgraftsincalfcadavermodel