In order to determine the effect of subfracture loads on articular
cartilage, we impacted twelve adult canine patellofemoral joints utilizing
a drop-tower with two different force-levels. The joints were examined with
light and electron microscopy at two, four, and six weeks after impaction.
In ten additional animals a single knee was impacted and they were analyzed
biochemically at similar time-periods, using the contralateral joint as a
control. In all impacted specimens changes were observed in the zone of
calcified cartilage, represented by an increase in cellular clones,
vascular invasion, and proteoglycan content of the matrix. Ultrastructural
evaluation of the superficial and deep radial zones of the articular
cartilage revealed loss of the cellular processes and territorial matrices
of chondrocytes in both layers. Ruthenium-red staining of impacted samples
revealed a 40 per cent decrease in proteoglycan associated with collagen
fibers in the extraterritorial matrix. An increase in collagen-fiber width
was observed in the four and six-week groups. The earliest changes in
articular cartilage included activation of the zone of calcified cartilage
as well as ultrastructural alterations in the superficial and radial zones.
Biochemical analysis revealed an increase in water content and hexuronic
acid at two weeks. These changes occurred at a subfracture level in the
absence of surface disruption. CLINICAL RELEVANCE: These animal experiments
indicate that adult articular cartilage may show significant alterations in
its histological, biochemical, and ultrastructural characteristics without
disruption of the articular surface. This model of articular cartilage
"contusion" may represent a corollary to the joint damage that is observed
following direct blunt trauma transmitted across articular surfaces without
radiographic evidence of fracture. The possibility that this form of injury
may be the precursor of chondromalacic changes in patellar or femoral
cartilage merits further study.