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Inoue T, Kano T, Nakasa T, Ishikawa M, Inoue K, Kawabata S, Miyaki S, Kamei N, Adachi N. Development of a novel approach for restoration of the meniscus using silk-elastin in a rabbit meniscus injury model. BMC Musculoskelet Disord 2024; 25:545. [PMID: 39010063 PMCID: PMC11247742 DOI: 10.1186/s12891-024-07675-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 07/08/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND Limited healing potential of the meniscus remains a burden for the successful repair of meniscus injuries in the orthopaedic fields. Silk-elastin (SE) is a novel recombinant protein with favorable properties for wound healing. This proof-of-concept study aimed to investigate the therapeutic effect of silk-elastin in a rabbit meniscal defect model. METHODS A migration assay using rabbit meniscus and synovial cells with various concentrations of SE in a culture medium was conducted to investigate the mechanism of meniscal healing by SE. Additionally, cylindrical defects with a 1.5 mm diameter were created at the anterior horn of the medial meniscus of rabbits. The animals were divided into three groups: 1) the Blank group; defect only, 2) the Col I group; implantation of type I atelocollagen sponge, and 3) the SE group; implantation of SE (150 mg/ml) sponge. Whole medial menisci were harvested at 4, 8, 12, and 24 weeks after surgery. Histological analyses including immunohistochemical staining were performed to assess meniscal healing. RESULTS In vitro study, Migration assay demonstrated a significantly higher number of migrated cells only in synovial cells. Especially, the SE concentration of 10 µg/mL demonstrated the highest number of migrated cells compared with other concentrations. In vivo study, the SE group exhibited significantly higher Ishida scores than other groups at all time points. Furthermore, the SE group showed higher synovial coverage scores than the Col I group at 4 and 8 weeks. Immunohistochemical staining demonstrated higher type II collagen staining in the SE group compared to other groups at 12 weeks. Implanted SE was efficiently replaced by safranin-O staining positive tissue within 8 weeks. CONCLUSIONS SE could effectively repair a meniscal defect by inducing coverage of synovial cells. SE has the potential to be a useful material for meniscal repair.
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Affiliation(s)
- Tadashi Inoue
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan
| | - Toshiya Kano
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan
| | - Tomoyuki Nakasa
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan.
| | - Masakazu Ishikawa
- Department of Artificial Joints and Biomaterials, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | | | | | - Shigeru Miyaki
- Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Hiroshima, Japan
| | - Naosuke Kamei
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan
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Torres-Claramunt R, Martínez-Díaz S, Sánchez-Soler JF, Tio-Barrera L, Arredondo R, Triginer L, Monllau JC. Fibronectin-coated polyurethane meniscal scaffolding supplemented with MSCs improves scaffold integration and proteoglycan production in a rabbit model. Knee Surg Sports Traumatol Arthrosc 2023; 31:5104-5110. [PMID: 37725106 DOI: 10.1007/s00167-023-07562-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 08/30/2023] [Indexed: 09/21/2023]
Abstract
PURPOSE The role of mesenchymal stem cells (MSC) in supporting the formation of new meniscal tissue in a meniscal scaffold is not well understood. The objective of this study was to assess the quality of the meniscal tissue produced in a fibronectin (FN)-coated polyurethane (PU) meniscal scaffold after a meniscal injury was made in an experimental rabbit model. METHODS Twelve New Zealand white rabbits were divided in two groups after performing a medial meniscectomy of the anterior horn. In group 1, the meniscal defect was reconstructed with a non-MSC supplemented FN-coated PU scaffold. On the other hand, the same scaffold supplemented with MSCs was used in group 2. The animals were sacrificed at 12 week after index surgery. A modified scoring system was used for histological assessment. This new scoring (ranging from 0 to 15) includes a structural evaluation (meniscal scaffold interface and extracellular matrix production) and tissue quality evaluation (proteoglycan and type I-collagen content). RESULTS The meniscal scaffold was found loose in the joint in three cases, corresponding to two cases in group 1 and 1 case in group 2. No differences were observed between the groups in terms of the total score (7.0 ± 0.9 vs. 9.4 ± 2.6, p = 0.09). However, differences were observed in group 2 in which 2 out of the 5 scored items, scaffold integration (1 ± 0.0 vs. 1.9 ± 0.6, p = 0.03) and proteoglycan production (1.2 ± 0.3 vs. 2.4 ± 0.2, p = 0.001). A trend to a higher production of Type I-Collagen production was also observed in group 2 (1.1 ± 0.4 vs. 1.4 ± 0.7, p = 0.05). CONCLUSION In a rabbit model at 12 weeks, the adhesion of MSCs to a FN-coated PU scaffold improves scaffold integration, proteoglycan production and the characteristics of the new meniscal-like tissue obtained when compared to a non-supplemented scaffold. This fact could be a major step toward improving the adhesion of the MSCs to meniscal scaffolds and, consequently, the obtention of better quality meniscal tissue.
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Affiliation(s)
- Raúl Torres-Claramunt
- Orthopaedic Department, Hospital del Mar, Universitat Autònoma Barcelona, Passeig Marítim de la Barceloneta 25-29, 08003, Barcelona, Spain.
- IMIM (Hospital del Mar Medical Research Institute), C/Dr. Aiguader 88, 08003, Barcelona, Spain.
- Orthopaedic Department, ICATME-Institut Universitari Quirón-Dexeus, Universitat Autònoma Barcelona, C/ Sabino de Arana 5-19, 08028, Barcelona, Spain.
| | - Santos Martínez-Díaz
- Orthopaedic Department, Hospital del Mar, Universitat Autònoma Barcelona, Passeig Marítim de la Barceloneta 25-29, 08003, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), C/Dr. Aiguader 88, 08003, Barcelona, Spain
| | - Juan F Sánchez-Soler
- Orthopaedic Department, Hospital del Mar, Universitat Autònoma Barcelona, Passeig Marítim de la Barceloneta 25-29, 08003, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), C/Dr. Aiguader 88, 08003, Barcelona, Spain
| | - Laura Tio-Barrera
- IMIM (Hospital del Mar Medical Research Institute), C/Dr. Aiguader 88, 08003, Barcelona, Spain
| | - Raquel Arredondo
- IMIM (Hospital del Mar Medical Research Institute), C/Dr. Aiguader 88, 08003, Barcelona, Spain
| | - Laura Triginer
- IMIM (Hospital del Mar Medical Research Institute), C/Dr. Aiguader 88, 08003, Barcelona, Spain
| | - Joan C Monllau
- IMIM (Hospital del Mar Medical Research Institute), C/Dr. Aiguader 88, 08003, Barcelona, Spain
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Induced Models of Osteoarthritis in Animal Models: A Systematic Review. BIOLOGY 2023; 12:biology12020283. [PMID: 36829562 PMCID: PMC9953428 DOI: 10.3390/biology12020283] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 02/15/2023]
Abstract
The most common induction methods for OA are mechanical, surgical and chemical. However, there is not a gold standard in the choice of OA animal models, as different animals and induction methods are helpful in different contexts. Reporting the latest evidence and results in the literature could help researchers worldwide to define the most appropriate indication for OA animal-model development. This review aims to better define the most appropriate animal model for various OA conditions. The research was conducted on the following literature databases: Medline, Embase, Cinahl, Scopus, Web of Science and Google Scholar. Studies reporting cases of OA in animal models and their induction from January 2010 to July 2021 were included in the study and reviewed by two authors. The literature search retrieved 1621 articles, of which 36 met the selection criteria and were included in this review. The selected studies included 1472 animals. Of all the studies selected, 8 included information about the chemical induction of OA, 19 were focused on mechanical induction, and 9 on surgical induction. Nevertheless, it is noteworthy that several induction models, mechanical, surgical and chemical, have been proven suitable for the induction of OA in animals.
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Li G, Liu S, Xu H, Chen Y, Deng J, Xiong A, Wang D, Weng J, Yu F, Gao L, Ding C, Zeng H. Potential effects of teriparatide (PTH (1-34)) on osteoarthritis: a systematic review. Arthritis Res Ther 2023; 25:3. [PMID: 36609338 PMCID: PMC9817404 DOI: 10.1186/s13075-022-02981-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 12/19/2022] [Indexed: 01/09/2023] Open
Abstract
Osteoarthritis (OA) is a common and prevalent degenerative joint disease characterized by degradation of the articular cartilage. However, none of disease-modifying OA drugs is approved currently. Teriparatide (PTH (1-34)) might stimulate chondrocyte proliferation and cartilage regeneration via some uncertain mechanisms. Relevant therapies of PTH (1-34) on OA with such effects have recently gained increasing interest, but have not become widespread practice. Thus, we launch this systematic review (SR) to update the latest evidence accordingly. A comprehensive literature search was conducted in PubMed, Web of Science, MEDLINE, the Cochrane Library, and Embase from their inception to February 2022. Studies investigating the effects of the PTH (1-34) on OA were obtained. The quality assessment and descriptive summary were made of all included studies. Overall, 307 records were identified, and 33 studies were included. In vivo studies (n = 22) concluded that PTH (1-34) slowed progression of OA by alleviating cartilage degeneration and aberrant remodeling of subchondral bone (SCB). Moreover, PTH (1-34) exhibited repair of cartilage and SCB, analgesic, and anti-inflammatory effects. In vitro studies (n = 11) concluded that PTH (1-34) was important for chondrocytes via increasing the proliferation and matrix synthesis but preventing apoptosis or hypertrophy. All included studies were assessed with low or unclear risk of bias in methodological quality. The SR demonstrated that PTH (1-34) could alleviate the progression of OA. Moreover, PTH (1-34) had beneficial effects on osteoporotic OA (OPOA) models, which might be a therapeutic option for OA and OPOA treatment.
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Affiliation(s)
- Guoqing Li
- grid.440601.70000 0004 1798 0578Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036 People’s Republic of China ,grid.440601.70000 0004 1798 0578National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036 People’s Republic of China
| | - Su Liu
- grid.440601.70000 0004 1798 0578Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036 People’s Republic of China ,grid.440601.70000 0004 1798 0578National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036 People’s Republic of China
| | - Huihui Xu
- grid.440601.70000 0004 1798 0578Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036 People’s Republic of China ,grid.440601.70000 0004 1798 0578National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036 People’s Republic of China
| | - Yixiao Chen
- grid.440601.70000 0004 1798 0578Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036 People’s Republic of China ,grid.440601.70000 0004 1798 0578National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036 People’s Republic of China
| | - Jiapeng Deng
- grid.440601.70000 0004 1798 0578Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036 People’s Republic of China ,grid.440601.70000 0004 1798 0578National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036 People’s Republic of China
| | - Ao Xiong
- grid.440601.70000 0004 1798 0578Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036 People’s Republic of China ,grid.440601.70000 0004 1798 0578National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036 People’s Republic of China
| | - Deli Wang
- grid.440601.70000 0004 1798 0578Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036 People’s Republic of China ,grid.440601.70000 0004 1798 0578National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036 People’s Republic of China
| | - Jian Weng
- grid.440601.70000 0004 1798 0578Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036 People’s Republic of China ,grid.440601.70000 0004 1798 0578National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036 People’s Republic of China
| | - Fei Yu
- grid.440601.70000 0004 1798 0578Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036 People’s Republic of China ,grid.440601.70000 0004 1798 0578National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036 People’s Republic of China
| | - Liang Gao
- Center for Clinical Medicine, Huatuo Institute of Medical Innovation (HTIMI), Berlin, Germany. .,Sino Euro Orthopaedics Network (SEON), Berlin, Germany.
| | - Changhai Ding
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, People's Republic of China.
| | - Hui Zeng
- Department of Bone & Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, 518036, People's Republic of China. .,National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen, 518036, People's Republic of China.
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Ai LY, Du MZ, Chen YR, Xia PY, Zhang JY, Jiang D. Integrated Analysis of lncRNA and mRNA Expression Profiles Indicates Age-Related Changes in Meniscus. Front Cell Dev Biol 2022; 10:844555. [PMID: 35359458 PMCID: PMC8960627 DOI: 10.3389/fcell.2022.844555] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 02/21/2022] [Indexed: 12/03/2022] Open
Abstract
Little has been known about the role of long non-coding RNA (lncRNA) involves in change of aged meniscus. Microarray analyses were performed to identify lncRNAs and mRNAs expression profiles of meniscus in young and aging adults and apple bioinformatics methods to analyse their potential roles. The differentially expressed (DE) lncRNAs and mRNAs were confirmed by qRT-PCR. A total of 1608 DE lncRNAs and 1809 DE mRNAs were identified. Functional and pathway enrichment analyses of all DE mRNAs showed that DE mRNAs were mainly involved in the TGF-beta, Wnt, Hippo, PI3K-Akt signaling pathway. The expressions of TNFRSF11B and BMP2 were significantly upregulated in aging group. LASSO logistic regression analysis of the DE lncRNAs revealed four lncRNAs (AC124312.5, HCG11, POC1B-AS1, and AP001011.1) that were associated with meniscus degradation. CNC analysis demonstrated that AP001011 inhibited the expression of TNFRSF11B and AC1243125 upregulated the expression of TNFRSF11B. CeRNA analysis suggested that POC1B-AS1 regulates the expression of BMP2 by sponging miR 130a-3p, miR136-5p, miR 18a-3p, and miR 608. Furthermore, subcellular localization and m6A modification sites prediction analysis of these four lncRNAs was performed. These data lay a foundation for extensive studies on the role of lncRNAs in change of aged meniscus.
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Affiliation(s)
- Li-Ya Ai
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China
- Institute of Sports Medicine of Peking University, Beijing, China
| | - Ming-Ze Du
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China
- Institute of Sports Medicine of Peking University, Beijing, China
| | - You-Rong Chen
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China
- Institute of Sports Medicine of Peking University, Beijing, China
| | - Peng-Yan Xia
- Department of Immunology, NHC Key Laboratory of Medical Immunology, School of Basic Medical Sciences, Peking University, Beijing, China
- Key Laboratory of Molecular Immunology, Chinese Academy of Medical Sciences, Beijing, China
| | - Ji-Ying Zhang
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China
- Institute of Sports Medicine of Peking University, Beijing, China
| | - Dong Jiang
- Department of Sports Medicine, Peking University Third Hospital, Beijing, China
- Institute of Sports Medicine of Peking University, Beijing, China
- *Correspondence: Dong Jiang,
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Bansal S, Floyd ER, Kowalski MA, Aikman E, Elrod P, Burkey K, Chahla J, LaPrade RF, Maher SA, Robinson JL, Patel JM. Meniscal repair: The current state and recent advances in augmentation. J Orthop Res 2021; 39:1368-1382. [PMID: 33751642 PMCID: PMC8249336 DOI: 10.1002/jor.25021] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 02/04/2021] [Accepted: 03/02/2021] [Indexed: 02/04/2023]
Abstract
Meniscal injuries represent one of the most common orthopedic injuries. The most frequent treatment is partial resection of the meniscus, or meniscectomy, which can affect joint mechanics and health. For this reason, the field has shifted gradually towards suture repair, with the intent of preservation of the tissue. "Save the Meniscus" is now a prolific theme in the field; however, meniscal repair can be challenging and ineffective in many scenarios. The objectives of this review are to present the current state of surgical management of meniscal injuries and to explore current approaches being developed to enhance meniscal repair. Through a systematic literature review, we identified meniscal tear classifications and prevalence, approaches being used to improve meniscal repair, and biological- and material-based systems being developed to promote meniscal healing. We found that biologic augmentation typically aims to improve cellular incorporation to the wound site, vascularization in the inner zones, matrix deposition, and inflammatory relief. Furthermore, materials can be used, both with and without contained biologics, to further support matrix deposition and tear integration, and novel tissue adhesives may provide the mechanical integrity that the meniscus requires. Altogether, evaluation of these approaches in relevant in vitro and in vivo models provides new insights into the mechanisms needed to salvage meniscal tissue, and along with regulatory considerations, may justify translation to the clinic. With the need to restore long-term function to injured menisci, biologists, engineers, and clinicians are developing novel approaches to enhance the future of robust and consistent meniscal reparative techniques.
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Affiliation(s)
- Sonia Bansal
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | | | | | - Kyley Burkey
- University of Kansas Medical Center, Kansas City, Kansas, USA
| | | | | | | | | | - Jay M. Patel
- Emory University, Atlanta, Georgia, USA
- Atlanta VA Medical Center, Decatur, Georgia, USA
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7
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Migliorini F, Berton A, Salvatore G, Candela V, Khan W, Longo UG, Denaro V. Autologous Chondrocyte Implantation and Mesenchymal Stem Cells for the Treatments of Chondral Defects of the Knee- A Systematic Review. Curr Stem Cell Res Ther 2021; 15:547-556. [PMID: 32081109 DOI: 10.2174/1574888x15666200221122834] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/23/2019] [Accepted: 01/09/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND There is still a lack of consensus about the best treatment of chondral defects of the knee. We conducted a systematic PRISMA review to evaluate clinical outcomes of Autologous Chondrocyte Implantation (ACI) and Mesenchymal Stem Cell (MSC) injections for the treatment of focal chondral defects of the knee. METHODS A systematic review of literature was performed according to the PRISMA guidelines. All the articles reporting data on ACI and MSC treatments for chondral defects of the knee were considered for inclusion. The main databases were accessed: PubMed, Medline, CINAHL, Cochrane, Embase and Google Scholar. The statistical analysis was performed using the Review Manager Software. RESULTS In the p-ACI group (987 knees), the Cincinnati Score improved by 18.94% (p=0.1), VAS by 38% (p=0.01), Tegner score by 19.11% (p=0.03), Lysholm score by 22.40% (p=0.01), IKCD by 27.36% (p=0.003). In the c-ACI group (444 knees), the Cincinnati Score improved by 23.80% (p=0.08), KOOS by 23.48% (p=0.03), VAS by 33.2% (p=0.005), IKDC by 33.30% (p=0.005). In the m-ACI group (599 knees), the Cincinnati Score improved by 26.80% (p=0.08), KOOS by 31.59% (p=0.1), VAS by 30.43% (p=0.4), Tegner score by 23.1% (p=0.002), Lysholm score by 31.14% (p=0.004), IKCD by 30.57% (p<0.001). In the MSCs group (291 knees), the KOOS improved by 29.7% (p=0.003), VAS by 41.89% (p<0.001), Tegner score by 25.81% (p=0.003), Lysholm score by 36.96% (p<0.001), IKCD by 30.57% (p=0.001). CONCLUSION Both ACI and MSC therapies can be considered as a concrete solution to treat focal chondral defects of the knee.
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Trigoria, Rome, Italy
| | - Alessandra Berton
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Trigoria, Rome, Italy
| | - Giuseppe Salvatore
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Trigoria, Rome, Italy
| | - Vincenzo Candela
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Trigoria, Rome, Italy
| | - Wasim Khan
- Division of Trauma & Orthopaedic Surgery, University of Cambridge, Addenbrooke's Hospital, Cambridge, CB2 2QQ, United Kingdom
| | - Umile G Longo
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Trigoria, Rome, Italy
| | - Vincenzo Denaro
- Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University, Via Alvaro del Portillo, 200, 00128 Trigoria, Rome, Italy
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Okuno N, Otsuki S, Aoyama J, Nakagawa K, Murakami T, Ikeda K, Hirose Y, Wakama H, Okayoshi T, Okamoto Y, Hirano Y, Neo M. Feasibility of a self-assembling peptide hydrogel scaffold for meniscal defect: An in vivo study in a rabbit model. J Orthop Res 2021; 39:165-176. [PMID: 32852842 DOI: 10.1002/jor.24841] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Revised: 06/19/2020] [Accepted: 08/18/2020] [Indexed: 02/04/2023]
Abstract
The inner avascular zone of the meniscus has limited healing capacity as the area is poorly vascularized. Although peptide hydrogels have been reported to regenerate bone and cartilage, their effect on meniscus regeneration remains unknown. We tested whether the self-assembling peptide hydrogel scaffold KI24RGDS stays in the meniscal lesion and facilitates meniscal repair and regeneration in an induced rabbit meniscal defect model. Full-thickness (2.0 mm diameter) cylindrical defects were introduced into the inner avascular zones of the anterior portions of the medial menisci of rabbit knees (n = 40). Right knee defects were left empty (control group) while the left knee defects were transplanted with peptide hydrogel (KI24RGDS group). Macroscopic meniscus scores were significantly higher in the KI24RGDS group than in the control group at 2, 4, and 8 weeks after surgery. Histological examinations including quantitative and qualitative scores indicated that compared with the control group, the reparative tissue in the meniscus was significantly enhanced in the KI24RGDS group at 2, 4, 8, and 12 weeks after surgery. Immunohistochemical staining showed that the reparative tissue induced by KI24RGDS at 12 weeks postimplantation was positive for Type I and II collagen. KI24RGDS is highly biocompatible and biodegradable, with strong stiffness, and a three dimensional structure mimicking native extracellular matrix and RGDS sequences that enhance cell adhesion and proliferation. This in vivo study demonstrated that KI24RGDS remained in the meniscal lesion and facilitated the repair and regeneration in a rabbit meniscal defect model.
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Affiliation(s)
- Nobuhiro Okuno
- Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan
| | - Shuhei Otsuki
- Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan
| | - Jo Aoyama
- Department of Chemistry and Materials Engineering, Faculty of Chemistry, Materials, and Bioengineering, Kansai University, Osaka, Japan
| | - Kosuke Nakagawa
- Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan
| | - Tomohiko Murakami
- Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan
| | - Kuniaki Ikeda
- Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan
| | | | - Hitoshi Wakama
- Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan
| | - Tomohiro Okayoshi
- Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan
| | - Yoshinori Okamoto
- Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan
| | - Yoshiaki Hirano
- Department of Chemistry and Materials Engineering, Faculty of Chemistry, Materials, and Bioengineering, Kansai University, Osaka, Japan
| | - Masashi Neo
- Department of Orthopedic Surgery, Osaka Medical College, Osaka, Japan
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Smoak JB, Matthews JR, Vinod AV, Kluczynski MA, Bisson LJ. An Up-to-Date Review of the Meniscus Literature: A Systematic Summary of Systematic Reviews and Meta-analyses. Orthop J Sports Med 2020; 8:2325967120950306. [PMID: 32953923 PMCID: PMC7485005 DOI: 10.1177/2325967120950306] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 04/09/2020] [Indexed: 12/14/2022] Open
Abstract
Background: A large number of systematic reviews and meta-analyses regarding the meniscus
have been published. Purpose: To provide a qualitative summary of the published systematic reviews and
meta-analyses regarding the meniscus. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic search of all meta-analyses and systematic reviews regarding the
meniscus and published between July 2009 and July 2019 was performed with
PubMed, CINAHL, EMBASE, and the Cochrane database. Published abstracts,
narrative reviews, articles not written in English, commentaries, study
protocols, and topics that were not focused on the meniscus were excluded.
The most pertinent results were extracted and summarized from each
study. Results: A total of 332 articles were found, of which 142 were included. Included
articles were summarized and divided into 16 topics: epidemiology,
diagnosis, histology, biomechanics, comorbid pathology, animal models,
arthroscopic partial meniscectomy (APM), meniscal repair, meniscal root
repairs, meniscal allograft transplantation (MAT), meniscal implants and
scaffolds, mesenchymal stem cells and growth factors, postoperative
rehabilitation, postoperative imaging assessment, patient-reported outcome
measures, and cost-effectiveness. The majority of articles focused on APM
(20%), MAT (18%), and meniscal repair (17%). Conclusion: This summary of systematic reviews and meta-analyses delivers surgeons a
single source of the current evidence regarding the meniscus.
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Affiliation(s)
- Jason B Smoak
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, Buffalo, New York, USA
| | - John R Matthews
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, Buffalo, New York, USA
| | - Amrit V Vinod
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, Buffalo, New York, USA
| | - Melissa A Kluczynski
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, Buffalo, New York, USA
| | - Leslie J Bisson
- Department of Orthopaedics, Jacobs School of Medicine and Biomedical Science, University at Buffalo, Buffalo, New York, USA
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10
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Brochhausen C, Grevenstein D, Mamilos A, Babel M, Eysel P. [Histological diagnostics in joint pathology due to increasing regenerative therapeutic strategies - special consideration for cartilage damage]. DER PATHOLOGE 2020; 41:271-280. [PMID: 32215684 DOI: 10.1007/s00292-020-00768-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Orthopedic and trauma surgery are currently confronted with significant changes in their interventional and therapeutic strategies, especially in knee surgery. Minimally invasive and reconstructive techniques lead not only to modifications of the repertoire of interventional methods but also of the indications and questions for histopathological diagnostics. The classical problems in knee surgery remain important issues, which are traumatic, degenerative, and infectious lesions. In addition, questions regarding regeneration and integration of cell-material constructs will become more and more important in the future. Furthermore, questions regarding the regenerative potential of an implantation site for such constructs and the morphological quality of harvested tissue for the in vitro cell expansion of autologous cells are becoming increasingly important. The autologous chondrocyte transplantation is a good example of the relevance of the histopathological re-evaluation of the regenerated tissue for a better understanding of the pathophysiology of reconstructive therapies. It becomes clear that for specific aims based on reconstructive therapies, new scoring systems should be established for the histopathological routine diagnostic service. Furthermore, there is need for the definition of further histopathological criteria, which will help to optimize the differential application of reconstructive strategies via tissue engineering. The present report gives a short overview of the modifying requirements on the histopathological diagnostics in specimens from knee-surgery but does not claim to be exhaustive.
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Affiliation(s)
- Christoph Brochhausen
- Institut für Pathologie, Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland. .,Zentrum für Rheumapathologie GmbH, Mainz, Deutschland.
| | - David Grevenstein
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Uniklinik Köln, Köln, Deutschland
| | - Andreas Mamilos
- Institut für Pathologie, Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland
| | | | - Peer Eysel
- Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Uniklinik Köln, Köln, Deutschland
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11
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Chen C, Song J, Qiu J, Zhao J. Repair of a Meniscal Defect in a Rabbit Model Through Use of a Thermosensitive, Injectable, In Situ Crosslinked Hydrogel With Encapsulated Bone Mesenchymal Stromal Cells and Transforming Growth Factor β1. Am J Sports Med 2020; 48:884-894. [PMID: 31967854 DOI: 10.1177/0363546519898519] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Meniscal injury repair with tissue engineering technique is promising. Among various scaffolds, the thermosensitive injectable hydrogel has recently attracted much attention. PURPOSE (1) Evaluate the biocompatibility of thermosensitive, injectable, in situ crosslinked hydrogel and (2) determine whether the hydrogel with or without transforming growth factor β1 (TGF-β1) could support the fibrochondrogenic differentiation of bone mesenchymal stromal cells (BMSCs) and promote the repair of a critical-sized defect in rabbit meniscus. STUDY DESIGN Controlled laboratory study. METHODS The rheological and sustained release properties of the hydrogel were demonstrated. BMSCs were isolated and cultured. Cell viability, quantitative polymerase chain reaction (qPCR), and Western blot were tested in vitro. In vivo, a critical-sized defect was introduced into the meniscus of 30 rabbits. Each defect was randomly assigned to be implanted with either phosphate-buffered saline (PBS); BMSC-laden hydrogel; or BMSC-laden, TGF-β1-incorporated hydrogel. Histological and immunohistochemical analyses were performed at 8 weeks after surgery. The Ishida scoring system was adopted to evaluate the healing quantitatively. RESULTS The elastic modulus of the hydrogel was about 1000 Pa. The hydrogel demonstrated a sustained-release property and could promote proliferation and induce fibrochondrogenic differentiation of BMSCs after the incorporation of TGF-β1 (P < .001). At 8 weeks after surgery, a large amount of fibrocartilaginous tissue, which was positive on safranin-O staining and expressed strong type II collagen intermingled with weak type I collagen, was observed in the defect region of the BMSC-laden, TGF-β1-incorporated hydrogel group. In the BMSC-laden hydrogel group, the defect was filled with fibrous tissue together with a small amount of fibrocartilage. The mean ± SD quantitative scores obtained for the 3 groups-PBS; BMSC-laden hydrogel; and BMSC-laden, TGF-β1-incorporated hydrogel-were 1.00, 3.20 ± 0.84, and 5.00 ± 0.71, respectively (P < .001). CONCLUSION The hydrogel was biocompatible and could stimulate strong fibrochondrogenic differentiation of BMSCs after the incorporation of TGF-β1. The local administration of the BMSC-laden, TGF-β1-incorporated hydrogel could promote the healing of rabbit meniscal injury. CLINICAL RELEVANCE This hydrogel is an alternative scaffold for meniscus tissue engineering.
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Affiliation(s)
- Chen Chen
- Department of Arthroscopic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.,State Key Laboratory of Molecular Engineering of Polymers, Fudan University, Shanghai, China
| | - Jialin Song
- The Orthopedic Department, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jiayu Qiu
- Department of Arthroscopic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jinzhong Zhao
- Department of Arthroscopic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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12
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Strauss E, Caborn DNM, Nyland J, Horng S, Chagnon M, Wilke D. Tissue healing following segmental meniscal allograft transplantation: a pilot study. Knee Surg Sports Traumatol Arthrosc 2019; 27:1931-1938. [PMID: 30656375 DOI: 10.1007/s00167-019-05355-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 01/11/2019] [Indexed: 10/27/2022]
Abstract
PURPOSE This in vivo histological study using an ovine model evaluated the 90-day healing of unilateral segmental meniscal allograft transplantation. METHODS Fresh-frozen medial menisci were transplanted to replace the right medial meniscus of six female sheep. Tissue healing was evaluated using semi-quantitative, descriptive methods. Formalin-fixed meniscal, distal femur and proximal tibia tissues were evaluated using Rodeo (cellularity/collagen), Ishida (reparative bonding), Collagen I IHC (collagen I), and Mankin (cartilage organization) scores at the medial femoral condyle (MFC) and medial tibial plateau (MTP). Meniscocapsular evaluations were performed at the: (a) peripheral junction; (b) posterior sector-native meniscus junction; (c) anterior sector-native meniscus junction; (d) posterior horn internal control; and (e) anterior horn internal control. RESULTS Three animals were euthanized at 39 ± 2.6 days post-surgery because of their knee condition. These animals had moderate Rodeo scores, low Ishida scores, and high Collagen I staining scores indicating moderately high fibrocartilaginous changes, mild or minimal healing and high collagen I content. Cartilage scores were low in the MFC and moderately high in the MTP, indicating mild MFC cartilage changes and moderately high MTP cartilage changes. Full-term (90 day) euthanized animals (n = 3) displayed improving Rodeo scores with mean scores of 3.3 and 3.6 at junctions (B) and (C), respectively. Ishida scores displayed similar improvements at all sectors. Collagen I staining revealed strong (grade 5) levels in all sections, with mean collagen I scores of 5, 5 and 4 for the peripheral (A), posterior (B) and anterior (C) junctions, respectively. Improved healing was observed at each segmental meniscus sector in terminally euthanized animals. CONCLUSIONS Segmental meniscal allograft transplantation displayed partial healing to remnant meniscal tissue. Further study is needed to better delineate the time needed for complete healing and the joint-loading progression that may enhance it.
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Affiliation(s)
- Eric Strauss
- NYU Center for Musculoskeletal Care, 333 East 38th Street, 4th Floor, New York, NY, 10016, USA
| | - David N M Caborn
- Department of Orthopaedic Surgery, University of Louisville, Louisville, KY, 40202, USA
| | - John Nyland
- Department of Orthopaedic Surgery, University of Louisville, Louisville, KY, 40202, USA.
| | - Sonida Horng
- AccelLab Inc., 1635 Lionel-Bertrand Blvd, Boisbriand, QC, J7H 1N8, Canada
| | - Madeleine Chagnon
- AccelLab Inc., 1635 Lionel-Bertrand Blvd, Boisbriand, QC, J7H 1N8, Canada
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13
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Shazeeb MS, Howes S, Kandasamy S, Peiris TB, Sotak CH, Pins GD. Developing quantitative MRI parameters to characterize host response and tissue ingrowth into collagen scaffolds. NMR IN BIOMEDICINE 2019; 32:e4059. [PMID: 30657204 DOI: 10.1002/nbm.4059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 11/19/2018] [Accepted: 11/20/2018] [Indexed: 06/09/2023]
Abstract
The in vivo evaluation of soft biomaterial implant remodeling routinely requires the surgical removal of the implant for subsequent histological assessment of tissue ingrowth and scaffold remodeling. This approach is very resource intensive, often destructive, and imposes practical limitations on how effectively these materials can be evaluated. MRI has the potential to non-invasively monitor the remodeling of implanted collagen scaffolds in real time. This study investigated the development of a model system to characterize the cellular infiltration, void area fraction, and angiogenesis in collagen scaffold implants using T2 relaxation time and apparent diffusion coefficient (ADC) maps along with conventional histological techniques. Initial correlations found statistically significant relationships between the MRI and histological parameters for various regions of the implanted sponges: T2 versus cell density (r ≈ -0.83); T2 versus void area fraction (r ≈ +0.78); T2 versus blood vessel density (r ≈ +0.95); ADC versus cell density (r ≈ -0.77); and ADC versus void area fraction (r ≈ +0.84). This suggests that MRI is sensitive to specific remodeling parameters and has the potential to serve as a non-invasive tool to monitor the remodeling of implanted collagen scaffolds, and to ultimately assess the ability of these scaffolds to regenerate the functional properties of damaged tissues such as tendons, ligaments, skin or skeletal muscle.
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Affiliation(s)
- Mohammed Salman Shazeeb
- Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Stuart Howes
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Sivakumar Kandasamy
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Thelge Buddika Peiris
- Department of Mathematical Sciences, Worcester Polytechnic Institute, Worcester, MA, USA
| | - Christopher H Sotak
- Department of Radiology, University of Massachusetts Medical School, Worcester, MA, USA
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, USA
- Department of Chemistry & Biochemistry, Worcester Polytechnic Institute, Worcester, MA, USA
| | - George D Pins
- Department of Biomedical Engineering, Worcester Polytechnic Institute, Worcester, MA, USA
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14
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In Vitro Testing of Scaffolds for Mesenchymal Stem Cell-Based Meniscus Tissue Engineering-Introducing a New Biocompatibility Scoring System. MATERIALS 2016; 9:ma9040276. [PMID: 28773399 PMCID: PMC5502969 DOI: 10.3390/ma9040276] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 03/14/2016] [Accepted: 03/29/2016] [Indexed: 12/22/2022]
Abstract
A combination of mesenchymal stem cells (MSCs) and scaffolds seems to be a promising approach for meniscus repair. To facilitate the search for an appropriate scaffold material a reliable and objective in vitro testing system is essential. This paper introduces a new scoring for this purpose and analyzes a hyaluronic acid (HA) gelatin composite scaffold and a polyurethane scaffold in combination with MSCs for tissue engineering of meniscus. The pore quality and interconnectivity of pores of a HA gelatin composite scaffold and a polyurethane scaffold were analyzed by surface photography and Berliner-Blau-BSA-solution vacuum filling. Further the two scaffold materials were vacuum-filled with human MSCs and analyzed by histology and immunohistochemistry after 21 days in chondrogenic media to determine cell distribution and cell survival as well as proteoglycan production, collagen type I and II content. The polyurethane scaffold showed better results than the hyaluronic acid gelatin composite scaffold, with signs of central necrosis in the HA gelatin composite scaffolds. The polyurethane scaffold showed good porosity, excellent pore interconnectivity, good cell distribution and cell survival, as well as an extensive content of proteoglycans and collagen type II. The polyurethane scaffold seems to be a promising biomaterial for a mesenchymal stem cell-based tissue engineering approach for meniscal repair. The new score could be applied as a new standard for in vitro scaffold testing.
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15
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Petzold J, Casadonte R, Otto M, Kriegsmann M, Granrath M, Baltzer A, Vogel J, Drees P, Deininger S, Becker M, Kriegsmann J. MALDI-Massenspektrometrie am Meniskus. Z Rheumatol 2014; 74:438-46. [DOI: 10.1007/s00393-014-1468-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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16
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Wang L, Wu Y, Tan Y, Fei X, Deng Y, Cao H, Chen B, Wang H, Magdalou J, Chen L. Cytotoxic effects of the quinolone levofloxacin on rabbit meniscus cells. J Appl Toxicol 2013; 34:870-7. [PMID: 23813946 DOI: 10.1002/jat.2903] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 05/11/2013] [Accepted: 05/11/2013] [Indexed: 12/31/2022]
Affiliation(s)
- Linlong Wang
- Department of Orthopedic Surgery; Zhongnan Hospital of Wuhan University; Wuhan 430071 China
| | - Yunpeng Wu
- Department of Orthopedic Surgery; Zhongnan Hospital of Wuhan University; Wuhan 430071 China
| | - Yang Tan
- Department of Orthopedic Surgery; Zhongnan Hospital of Wuhan University; Wuhan 430071 China
| | - Xi Fei
- Department of Orthopedic Surgery; Zhongnan Hospital of Wuhan University; Wuhan 430071 China
| | - Yu Deng
- Department of Orthopedic Surgery; Zhongnan Hospital of Wuhan University; Wuhan 430071 China
| | - Hong Cao
- Department of Orthopedic Surgery; Zhongnan Hospital of Wuhan University; Wuhan 430071 China
| | - Biao Chen
- Department of Orthopedic Surgery; Zhongnan Hospital of Wuhan University; Wuhan 430071 China
| | - Hui Wang
- Department of Pharmacology; Basic Medical School of Wuhan University; Wuhan 430071 China
| | - Jacques Magdalou
- UMR 7365 CNRS-Nancy Université; Faculté de Médicine; Vandoeuvre-lès-Nancy France
| | - Liaobin Chen
- Department of Orthopedic Surgery; Zhongnan Hospital of Wuhan University; Wuhan 430071 China
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