To examine the effects of transarticular loading on articular cartilage
and subchondral bone, we used a canine model that we had developed
previously, in which a standardized load of approximately 2000 newtons is
delivered across the patellofemoral joint. The purpose of the study was to
define and describe the initial changes, as seen on histopathological and
magnetic resonance-imaging studies, that occur in the early stages after
injury to the joint by transarticular loading. Scanning electron microscopy
was used to define the extent and characteristics of the fractures produced
in the subchondral bone of four patellae that were examined on the day of
loading. We found multiple, extensive fractures through the zone of
calcified cartilage and the subchondral bone, frequently with step-off
displacement, and with little or no change in the gross appearance of the
articular cartilage. Specimens from four patellae were examined
histologically two weeks after loading, and the observed changes were
correlated with those that had been demonstrated by scanning electron
microscopy. Fractures through the zone of calcified cartilage and the
subchondral bone, with step-off displacement, were prominent. Clefts were
present in the surface of the articular cartilage and, in some areas, there
was a focal loss of proteoglycan from the extracellular matrix, as
indicated by the complete absence of staining with safranin O. Six dogs
were examined one year after loading. There was healing of the subchondral
fractures and restoration of proteoglycan in the extracellular matrix.
However, superficial clefts and fissures were still present in the
articular cartilage. Sequential magnetic resonance-imaging studies were
also carried out on these six dogs, at two, eight, sixteen, thirty-six, and
fifty-two weeks after loading. Two weeks after loading, all knees had
soft-tissue swelling, effusion, and a decreased marrow signal in the
medullary cavity of the patella. The decreased marrow signal and effusion
were still present eight weeks after the impact, and then the findings
gradually returned to normal. One year after loading, it was found that the
histopathological changes had not been progressive; in fact, they had been
ameliorated and, to some extent, reversed by repair processes. The early,
severe magnetic resonance-imaging changes had also been reversed, so that
this study demonstrated normal findings by one year after loading.