The Degree of Chondral Fragmentation Affects Extracellular Matrix Production in Cartilage Autograft Implantation: An In Vitro Study

Purpose To evaluate if the degree of chondral fragmentation affected extracellular matrix (ECM) production in cartilage fragment autograft implantation in vitro. Methods Cartilage was taken from 5 donors undergoing total hip replacement (mean age, 65.6 years; standard deviation [SD], 3). The cartilage was minced to obtain 4 groups with different fragment sizes: (1) "fish scale" (diameter, 8 mm; thickness, 0.3 mm), (2) cubes with 2-mm sides, (3) cubes with 1-mm sides, and (4) cartilage paste ( Results Regarding the PG:DNA ratio, group 4 performed significantly better than groups 1 ( P  = .001) and 3 ( P  = .02), whereas group 2 performed better than group 1 ( P  = .03). No significant difference was found regarding the PGrel:PG ratio and safranin O–positive cells. Regarding the Bern score, group 4 performed significantly better than groups 1 ( P  = .02), 2 ( P  = .04), and 3 ( P  = .03). Conclusions We conclude that human cartilage fragmentation significantly affects ECM production in vitro. Increased fragmentation enhances ECM production. Clinical Relevance Assuming a similar behavior in vivo, we recommend mincing the cartilage into small pieces when performing the cartilage fragment autograft implantation technique in order to increase ECM production. Further in vitro studies investigating cartilage of younger nonarthritic donors, as well as in vivo studies, are needed.