The Role of Subchondral Bone Integrity in Articular Cartilage Repair

The role of subchondral bone integrity in articular cartilage repair remains unclear. In a preclinical articular cartilage model, penetration of the subchondral bone plate below the defect area resulted in subchondral bone cyst formation. Aspiration of bone marrow from the intercondylar notch as a subchondral bone-sparing technique and implantation into the cartilage defect did not prevent cyst formation and did not improve cartilage healing. Retrospective analysis of clinically failed Matrix-Assisted Chondrocyte Implantation (MACI) specimens demonstrated failure of the osteochondral unit, rather than failure of cartilage repair tissue. Subchondral bone integrity appears important in articular cartilage repair techniques.