Objective

The purpose of this study was to determine if differences in Wiberg classification play a role in the ability of donor patellar osteochondral allografts to match the native patellar surface when treating osteochondral defects of the patellar apex.

Design

Twenty (10 Wiberg I and 10 Wiberg II/III) human patellae were designated as the recipient. Each recipient was size-matched to both a Wiberg I and a Wiberg II/III patellar donor. A 16-mm circular osteochondral “defect” was created on the central ridge of the recipient patella. The randomly ordered donor Wiberg I or Wiberg II/III plug was harvested from a homologous location and transplanted into the recipient. The recipient was then nano-CT (computed tomography) scanned, digitally reconstructed, registered to the initial nano-CT scan of the recipient patella, and processed to determine root mean squared circumferential step-off heights as well as surface height deviation. The process was then repeated for the other allograft plug.

Results

There was no significant difference in mean step-off height between matched and unmatched Wiberg plugs; however, there was a statistically significant difference in surface height deviation over the whole surface (0.50 mm and 0.64 mm respectively, P = 0.03). This difference of 0.14 mm is not felt to be clinically significant. Tibial width was correlated to patellar width (r = 0.82) and patellar height (r = 0.68).

Conclusions

For osteochondral allograft sizes up to 16 mm there appears to be no advantage to match donor and recipient patellar morphology. Further study is warranted to evaluate defects requiring larger graft sizes.

中文翻译：

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在为涉及髌骨中央脊的骨软骨缺损匹配骨软骨同种异体移植物时，髌骨形态的对称性是否重要？

客观的

本研究的目的是确定在治疗髌尖骨软骨缺损时，Wiberg 分类的差异是否在供体髌骨软骨同种异体移植物与天然髌骨表面匹配的能力中起作用。

设计

二十个（10 个 Wiberg I 和 10 个 Wiberg II/III）人类髌骨被指定为接受者。每个接受者的大小都与 Wiberg I 和 Wiberg II/III 髌骨供体相匹配。在受者髌骨的中央脊上形成一个 16 毫米的圆形骨软骨“缺损”。从同源位置收获随机排序的供体 Wiberg I 或 Wiberg II/III 栓并移植到受体中。然后对接受者进行纳米 CT（计算机断层扫描）扫描、数字重建、注册到接受者髌骨的初始纳米 CT 扫描，并进行处理以确定均方根圆周步距高度以及表面高度偏差。然后对另一个同种异体移植物塞重复该过程。

结果

匹配和不匹配的 Wiberg 插头之间的平均台阶高度没有显着差异；然而，整个表面的表面高度偏差存在统计学上的显着差异（分别为 0.50 毫米和 0.64 毫米，P = 0.03）。这种 0.14 毫米的差异在临床上并不显着。胫骨宽度与髌骨宽度（r = 0.82）和髌骨高度（r = 0.68）相关。

结论

对于高达 16 mm 的骨软骨同种异体移植物，匹配供体和受体的髌骨形态似乎没有优势。需要进一步研究来评估需要更大移植尺寸的缺陷。