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Barui S, Ghosh D, Laurencin CT. Osteochondral regenerative engineering: challenges, state-of-the-art and translational perspectives. Regen Biomater 2022; 10:rbac109. [PMID: 36683736 PMCID: PMC9845524 DOI: 10.1093/rb/rbac109] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/22/2022] [Accepted: 12/09/2022] [Indexed: 12/27/2022] Open
Abstract
Despite quantum leaps, the biomimetic regeneration of cartilage and osteochondral regeneration remains a major challenge, owing to the complex and hierarchical nature of compositional, structural and functional properties. In this review, an account of the prevailing challenges in biomimicking the gradients in porous microstructure, cells and extracellular matrix (ECM) orientation is presented. Further, the spatial arrangement of the cues in inducing vascularization in the subchondral bone region while maintaining the avascular nature of the adjacent cartilage layer is highlighted. With rapid advancement in biomaterials science, biofabrication tools and strategies, the state-of-the-art in osteochondral regeneration since the last decade has expansively elaborated. This includes conventional and additive manufacturing of synthetic/natural/ECM-based biomaterials, tissue-specific/mesenchymal/progenitor cells, growth factors and/or signaling biomolecules. Beyond the laboratory-based research and development, the underlying challenges in translational research are also provided in a dedicated section. A new generation of biomaterial-based acellular scaffold systems with uncompromised biocompatibility and osteochondral regenerative capability is necessary to bridge the clinical demand and commercial supply. Encompassing the basic elements of osteochondral research, this review is believed to serve as a standalone guide for early career researchers, in expanding the research horizon to improve the quality of life of osteoarthritic patients affordably.
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Affiliation(s)
- Srimanta Barui
- Connecticut Convergence Institute for Translation in Regenerative Engineering, University of Connecticut Health Center, Farmington, CT 06030, USA
| | - Debolina Ghosh
- Connecticut Convergence Institute for Translation in Regenerative Engineering, University of Connecticut Health Center, Farmington, CT 06030, USA
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Cao Y, Sun L, Liu Z, Shen Z, Jia W, Hou P, Sang S. 3D printed-electrospun PCL/hydroxyapatite/MWCNTs scaffolds for the repair of subchondral bone. Regen Biomater 2022; 10:rbac104. [PMID: 36683741 PMCID: PMC9847519 DOI: 10.1093/rb/rbac104] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 11/28/2022] [Accepted: 12/09/2022] [Indexed: 12/15/2022] Open
Abstract
Osteochondral defect caused by trauma or osteoarthritis exhibits a major challenge in clinical treatment with limited symptomatic effects at present. The regeneration and remodeling of subchondral bone play a positive effect on cartilage regeneration and further promotes the repair of osteochondral defects. Making use of the strengths of each preparation method, the combination of 3D printing and electrospinning is a promising method for designing and constructing multi-scale scaffolds that mimic the complexity and hierarchical structure of subchondral bone at the microscale and nanoscale, respectively. In this study, the 3D printed-electrospun poly(ɛ-caprolactone)/nano-hydroxyapatites/multi-walled carbon nanotubes (PCL/nHA/MWCNTs) scaffolds were successfully constructed by the combination of electrospinning and layer-by-layer 3D printing. The resulting dual-scale scaffold consisted of a dense layer of disordered nanospun fibers and a porous microscale 3D scaffold layer to support and promote the ingrowth of subchondral bone. Herein, the biomimetic PCL/nHA/MWCNTs scaffolds enhanced cell seeding efficiency and allowed for higher cell-cell interactions that supported the adhesion, proliferation, activity, morphology and subsequently improved the osteogenic differentiation of bone marrow mesenchymal stem cells in vitro. Together, this study elucidates that the construction of 3D printed-electrospun PCL/nHA/MWCNTs scaffolds provides an alternative strategy for the regeneration of subchondral bone and lays a foundation for subsequent in vivo studies.
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Affiliation(s)
- Yanyan Cao
- College of Information Science and Engineering, Hebei North University, Zhangjiakou 075000, China,Shanxi Key Laboratory of Micro Nano Sensors & Artificial Intelligence Perception, College of Information and Computer, Taiyuan University of Technology, Taiyuan 030024, China
| | - Lei Sun
- Shanxi Key Laboratory of Micro Nano Sensors & Artificial Intelligence Perception, College of Information and Computer, Taiyuan University of Technology, Taiyuan 030024, China,Key Lab of Advanced Transducers and Intelligent Control System of the Ministry of Education, Taiyuan University of Technology, Taiyuan 030024, China
| | - Zixian Liu
- Shanxi Key Laboratory of Micro Nano Sensors & Artificial Intelligence Perception, College of Information and Computer, Taiyuan University of Technology, Taiyuan 030024, China,Key Lab of Advanced Transducers and Intelligent Control System of the Ministry of Education, Taiyuan University of Technology, Taiyuan 030024, China
| | - Zhizhong Shen
- Shanxi Key Laboratory of Micro Nano Sensors & Artificial Intelligence Perception, College of Information and Computer, Taiyuan University of Technology, Taiyuan 030024, China,Shanxi Research Institute of 6D Artificial Intelligence Biomedical Science, Taiyuan 030031, China
| | - Wendan Jia
- Shanxi Key Laboratory of Micro Nano Sensors & Artificial Intelligence Perception, College of Information and Computer, Taiyuan University of Technology, Taiyuan 030024, China,Shanxi Research Institute of 6D Artificial Intelligence Biomedical Science, Taiyuan 030031, China
| | - Peiyi Hou
- Shanxi Key Laboratory of Micro Nano Sensors & Artificial Intelligence Perception, College of Information and Computer, Taiyuan University of Technology, Taiyuan 030024, China,Shanxi Research Institute of 6D Artificial Intelligence Biomedical Science, Taiyuan 030031, China
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On-lay grafting of a calcium hydroxyapatite bone substitute: A preliminary animal experimental study. J Orthop Sci 2020; 25:1101-1106. [PMID: 32046936 DOI: 10.1016/j.jos.2019.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 11/26/2019] [Accepted: 12/27/2019] [Indexed: 01/15/2023]
Abstract
BACKGROUND Bone substitutes are widely accepted for various clinical applications. However, the usage is predominantly intraosseous implantation, whereas extraosseous on-lay grafting is rare and lacks scientific evidence. The purpose of this study is to elucidate whether osteoconduction occurs in on-lay grafted bone substitute. METHODS Custom-made interconnected porous calcium hydroxyapatite ceramic (IPCHA) was on-lay grafted with screw or anchor fixation (S- and A-groups, respectively) at the anterior aspect of the femur of skeletally mature Japanese white rabbits. At 3, 6 and 12 weeks postoperatively, 4 samples for each time point and each group were evaluated by microfocus computed tomography (micro-CT) and histology. RESULTS Volume-rendered three-dimensional micro-CT images showed a high-density calcified area infiltrating IPCHA from the femoral cortex as of 6 weeks. When quantified, the calcified volume per unit volume first showed no difference between the two groups at 3 weeks but increased over time, and became significantly greater in the S-group than in the A-group (p = 0.012 and 0.004 at 6 and 12 weeks, respectively). Histologically, IPCHA pores were first occupied by fibrous tissue at 3 weeks; then, the pores adjacent to the femoral cortex were gradually replaced by bony tissue as of 6 weeks for both fixations. CONCLUSIONS IPCHA allowed new bone formation inside the material even though it was implanted in an on-lay fashion on the cortical bone. Our results suggested that on-lay grafted IPCHA exerted its osteoconductivity well, with more new bone forming in screw-fixated samples than in anchor-fixated samples.
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Salonius E, Muhonen V, Lehto K, Järvinen E, Pyhältö T, Hannula M, Aula AS, Uppstu P, Haaparanta A, Rosling A, Kellomäki M, Kiviranta I. Gas‐foamed poly(lactide‐co‐glycolide) and poly(lactide‐co‐glycolide) with bioactive glass fibres demonstrate insufficient bone repair in lapine osteochondral defects. J Tissue Eng Regen Med 2019; 13:406-415. [DOI: 10.1002/term.2801] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 10/10/2018] [Accepted: 12/17/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Eve Salonius
- Department of Orthopaedics and Traumatology, Clinicum, Faculty of MedicineUniversity of Helsinki Helsinki Finland
| | - Virpi Muhonen
- Department of Orthopaedics and Traumatology, Clinicum, Faculty of MedicineUniversity of Helsinki Helsinki Finland
| | - Kalle Lehto
- Department of Electronics and Communications EngineeringTampere University of Technology, BioMediTech, Institute of Biosciences and Medical Technology Tampere Finland
| | - Elina Järvinen
- Department of Orthopaedics and Traumatology, Clinicum, Faculty of MedicineUniversity of Helsinki Helsinki Finland
| | - Tuomo Pyhältö
- Department of Orthopaedics and TraumatologyHelsinki University Hospital Helsinki Finland
| | - Markus Hannula
- Department of Electronics and Communications EngineeringTampere University of Technology, BioMediTech, Institute of Biosciences and Medical Technology Tampere Finland
| | - Antti S. Aula
- Department of Electronics and Communications EngineeringTampere University of Technology, BioMediTech, Institute of Biosciences and Medical Technology Tampere Finland
- Department of Medical Physics, Imaging CentreTampere University Hospital Tampere Finland
| | - Peter Uppstu
- Laboratory of Polymer Technology, Centre of Excellence in Functional Materials at Biological InterfacesÅbo Akademi University Turku Finland
| | - Anne‐Marie Haaparanta
- Department of Electronics and Communications EngineeringTampere University of Technology, BioMediTech, Institute of Biosciences and Medical Technology Tampere Finland
| | - Ari Rosling
- Laboratory of Polymer Technology, Centre of Excellence in Functional Materials at Biological InterfacesÅbo Akademi University Turku Finland
| | - Minna Kellomäki
- Department of Electronics and Communications EngineeringTampere University of Technology, BioMediTech, Institute of Biosciences and Medical Technology Tampere Finland
| | - Ilkka Kiviranta
- Department of Orthopaedics and Traumatology, Clinicum, Faculty of MedicineUniversity of Helsinki Helsinki Finland
- Department of Orthopaedics and TraumatologyHelsinki University Hospital Helsinki Finland
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Dias IR, Viegas CA, Carvalho PP. Large Animal Models for Osteochondral Regeneration. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1059:441-501. [PMID: 29736586 DOI: 10.1007/978-3-319-76735-2_20] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Namely, in the last two decades, large animal models - small ruminants (sheep and goats), pigs, dogs and horses - have been used to study the physiopathology and to develop new therapeutic procedures to treat human clinical osteoarthritis. For that purpose, cartilage and/or osteochondral defects are generally performed in the stifle joint of selected large animal models at the condylar and trochlear femoral areas where spontaneous regeneration should be excluded. Experimental animal care and protection legislation and guideline documents of the US Food and Drug Administration, the American Society for Testing and Materials and the International Cartilage Repair Society should be followed, and also the specificities of the animal species used for these studies must be taken into account, such as the cartilage thickness of the selected defect localization, the defined cartilage critical size defect and the joint anatomy in view of the post-operative techniques to be performed to evaluate the chondral/osteochondral repair. In particular, in the articular cartilage regeneration and repair studies with animal models, the subchondral bone plate should always be taken into consideration. Pilot studies for chondral and osteochondral bone tissue engineering could apply short observational periods for evaluation of the cartilage regeneration up to 12 weeks post-operatively, but generally a 6- to 12-month follow-up period is used for these types of studies.
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Affiliation(s)
- Isabel R Dias
- Department of Veterinary Sciences, Agricultural and Veterinary Sciences School, University of Trás-os-Montes e Alto Douro (UTAD), Vila Real, Portugal. .,3B's Research Group - Biomaterials, Biodegradables and Biomimetics, Department of Polymer Engineering, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark - Parque da Ciência e Tecnologia, Zona Industrial da Gandra, Barco - Guimarães, 4805-017, Portugal. .,Department of Veterinary Medicine, ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.
| | - Carlos A Viegas
- Department of Veterinary Sciences, Agricultural and Veterinary Sciences School, University of Trás-os-Montes e Alto Douro (UTAD), Vila Real, Portugal.,3B's Research Group - Biomaterials, Biodegradables and Biomimetics, Department of Polymer Engineering, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, AvePark - Parque da Ciência e Tecnologia, Zona Industrial da Gandra, Barco - Guimarães, 4805-017, Portugal.,Department of Veterinary Medicine, ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Pedro P Carvalho
- Department of Veterinary Medicine, University School Vasco da Gama, Av. José R. Sousa Fernandes 197, Lordemão, Coimbra, 3020-210, Portugal.,CIVG - Vasco da Gama Research Center, University School Vasco da Gama, Coimbra, Portugal
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Abstract
Partial tibial plateau fractures may occur as a consequence of either valgus or varus trauma combined with a rotational and axial compression component. High-energy trauma may result in a more complex and multi-fragmented fracture pattern, which occurs predominantly in young people. Conversely, a low-energy mechanism may lead to a pure depression fracture in the older population with weaker bone density. Pre-operative classification of these fractures, by Müller AO, Schatzker or novel CT-based methods, helps to understand the fracture pattern and choose the surgical approach and treatment strategy in accordance with estimated bone mineral density and the individual history of each patient.
Non-operative treatment may be considered for non-displaced intra-articular fractures of the lateral tibial condyle. Intra-articular joint displacement ⩾ 2 mm, open fractures or fractures of the medial condyle should be reduced and fixed operatively. Autologous, allogenic and synthetic bone substitutes can be used to fill bone defects. A variety of minimally invasive approaches, temporary osteotomies and novel techniques (e.g. arthroscopically assisted reduction or ‘jail-type’ screw osteosynthesis) offer a range of choices for the individual and are potentially less invasive treatments. Rehabilitation protocols should be carefully planned according to the degree of stability achieved by internal fixation, bone mineral density and other patient-specific factors (age, compliance, mobility). To avoid stiffness, early functional mobilisation plays a major role in rehabilitation. In the elderly, low-energy trauma and impression fractures are indicators for the further screening and treatment of osteoporosis.
Cite this article: EFORT Open Rev 2017;2. DOI: 10.1302/2058-5241.2.160067. Originally published online at www.efortopenreviews.org
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Affiliation(s)
- Michael J Raschke
- Department of Trauma, Hand and Reconstructive Surgery, Westphaelian Wilhelms University Muenster, Waldeyer Strasse 1, 48149 Muenster, Germany
| | - Christoph Kittl
- Department of Trauma, Hand and Reconstructive Surgery, Westphaelian Wilhelms University Muenster, Waldeyer Strasse 1, 48149 Muenster, Germany
| | - Christoph Domnick
- Department of Trauma, Hand and Reconstructive Surgery, Westphaelian Wilhelms University Muenster, Waldeyer Strasse 1, 48149 Muenster, Germany
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