The restoration of articular surfaces overlying replamineform porous biomaterials

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Abstract
Replamineform porous implants (4 mm × 4 mm diameter) were placed into full‐thickness cartilage and bone defects of the weight‐bearing surface of the lateral femoral condyles of adult male white rabbits. These were analyzed at 1 day, 1 week, 6 weeks, 3 months, and 6 months for (1) ingrowth of tissue within the implants and (2) restoration of the articular surface overlying them. Appropriate unfilled, but similar, control defects were also studied. Mineralized bone was seen within the substance of both the TiO2 and hydroxyapatite implants at 1 week; this extremely rapid response was present in every specimen studied and was not seen with αAl2O3 or control animals. With the passage of time, maturation of this bone ingrowth occurred so that by 3 months, they were all incorportated into the surrounding bone. Only the hydroxyapatite implants showed consistent regenerative healing of hyaline articular cartilage from the margins of the defects with the passage of time; this occurred whenever the subchondral bone adjacent to the defect proliferated in a “creeping” fashion over the articular aspect of the implant, and the undamaged cartilage then followed it. Fibrocartilage, and not hyaline cartilage, formed the articular surface over the TiO2 and αAl2O3 implants and in the controls.