Parylene scaffold for cartilage lesion

Trochlear Dysplasia Does Not Affect the Outcomes of Patellofemoral Autologous Chondrocyte Implantation

PURPOSE

To evaluate the influence of trochlear dysplasia on clinical outcomes after autologous chondrocyte implantation (ACI) for the treatment of large cartilage lesions in the patellofemoral joint (PFJ) with a minimum of 2 years' follow-up.

METHODS

We performed a retrospective review of prospectively collected data of all patients submitted to cartilage repair with ACI for focal cartilage defects in the PFJ by a single surgeon. Patient factors, lesion morphology, and preoperative and postoperative patient-reported outcome measures including the Knee Injury and Osteoarthritis Score, Lysholm score, Tegner activity level, and International Knee Documentation Committee Subjective Knee Evaluation Form score were collected. Two independent observers assessed preoperative imaging to determine the presence and grade of trochlear dysplasia. Patients were stratified into 2 groups based on the presence or absence of trochlear dysplasia. Patients without trochlear dysplasia served as controls. Patients were matched 1:1 for sex, age, body mass index, lesion size, and location.

RESULTS

Forty-six patients who underwent ACI in the PFJ with a mean follow-up period of 3.7 ± 1.9 years (range, 2-9 years) were enrolled in this study (23 in the trochlear dysplasia group vs 23 in the normal trochlea group). The patients' mean age was 30.1 ± 8.8 years. Patient-reported outcome measures at final follow-up did not differ between the 2 groups (P > .05). No difference in failure rates was seen between the 2 groups (n = 1 [4.3%] vs n = 1 [4.3%], P > .999). Additionally, no difference in clinical outcomes was seen between patients with high-grade dysplasia (19 patients; Dejour types B-D) and patients without dysplasia (19 patients) (P > .05).

CONCLUSIONS

ACI in the PFJ provides favorable outcomes even in patients with trochlear dysplasia, which are comparable to those in patients with normal trochlear anatomy. Thus, trochlear dysplasia seems to not influence the clinical outcomes of ACI in the PFJ.

LEVEL OF EVIDENCE

Level III, retrospective comparative trial.

Vapor-deposited functional polymer thin films in biological applications

Functional polymer coatings have become ubiquitous in biological applications, ranging from biomaterials and drug delivery to manufacturing-scale separation of biomolecules using functional membranes. Recent advances in the technology of chemical vapor deposition (CVD) have enabled precise control of the polymer chemistry, coating thickness, and conformality. That comprehensive control of surface properties has been used to elicit desirable interactions at the interface between synthetic materials and living organisms, making vapor-deposited functional polymers uniquely suitable for biological applications. This review captures the recent technological development in vapor-deposited functional polymer coatings, highlighting their biological applications, including membrane-based bio-separations, biosensing and bio-MEMS, drug delivery, and tissue engineering. The conformal nature of vapor-deposited coatings ensures uniform coverage over micro- and nano-structured surfaces, allowing the independent optimization of surface and bulk properties. The substrate-independence of CVD techniques enables facile transfer of surface characteristics among different applications. The vapor-deposited functional polymer thin films tend to be biocompatible because they are free of remnant toxic solvents and precursor molecules, potentially lowering the barrier to clinical success.

3D Printing of Cell Culture Devices: Assessment and Prevention of the Cytotoxicity of Photopolymers for Stereolithography

3D printing is increasingly important for the rapid prototyping of advanced and tailor-made cell culture devices. In this context, stereolithography represents a method for the rapid generation of prototypes from photocurable polymers. However, the biocompatibility of commercially available photopolymers is largely unknown. Therefore, we evaluated the cytotoxicity of six polymers, two of them certified as biocompatible according to ISO 10993-5:2009, and we evaluated, if coating with Parylene, an inert polymer widely used in medical applications, might shield cells from the cytotoxic effects of a toxic polymer. In addition, we evaluated the processability, reliability, and consistency of the details printed. Human mesenchymal stem cells (MSCs) were used for cytotoxicity testing as they are widely used and promising for numerous applications in regenerative medicine. MSCs were incubated together with printed photopolymers, and the cytotoxicity was assessed. All photopolymers significantly reduced the viability of MSCs while the officially biocompatible resins displayed minor toxic effects. Further, coating with Parylene completely protected MSCs from toxic effects. In conclusion, none of the tested polymers can be fully recommended for rapid prototyping of cell culture devices. However, coating with Parylene can shield cells from toxic effects and thus might represent a viable option until more compatible materials are available.

Parylene-C coated microporous PDMS structure protecting from functional deconditioning of platelets exposed to cardiostimulants

Most elderly patients after orthopedic and dental implant surgeries are exposed to cardiostimulants to reduce potential blood pressure-related risks of cardiovascular diseases. Such treatments lead to deconditioning of platelet function, which is an important factor in wound healing treatments. We introduced an innovative parylene-C coated microporous PDMS structure that can prevent the functional deconditioning of platelets caused by certain cardiostimulants. At different concentrations of cardiostimulants (IPR; isoprenaline and DA; dopamine), pre-activation, activation, and post-activation of platelets were intensively examined under mechanical and chemical stimulation mimicking the physiological environment on four different surfaces (glass, flat parylene-C coated glass (F-PPXC), microporous PDMS structure (P-PDMS), and parylene-C-coated microporous PDMS structure (S-PPXC)). The 3D microporous structure with parylene-C (S-PPXC) surface could attenuate the deconditioning of platelet function caused by IPR. Moreover, the S-PPXC surface further enhanced the DA-dependent stimulation of platelet function. The reason for this is that the 3D microporous structure with parylene-C S-PPXC induced stable and fast adhesion of platelets through increased surface roughness and softness, resulting in a significant enhancement of platelet activity. Therefore, we propose the use of functional S-PPXC surfaces as a novel strategy in the development of biomedical products.