Novel multilayer meniscal scaffold provides biomechanical and histological results comparable to polyurethane scaffolds: An 8 week rabbit study

Post-Traumatic Osteoarthritis Assessment in Emerging and Advanced Pre-Clinical Meniscus Repair Strategies: A Review

Surgical repair of meniscus injury is intended to help alleviate pain, prevent further exacerbation of the injury, restore normal knee function, and inhibit the accelerated development of post-traumatic osteoarthritis (PTOA). Meniscus injuries that are treated poorly or left untreated are reported to significantly increase the risk of PTOA in patients. Current surgical approaches for the treatment of meniscus injuries do not eliminate the risk of accelerated PTOA development. Through recent efforts by scientists to develop innovative and more effective meniscus repair strategies, the use of biologics, allografts, and scaffolds have come into the forefront in pre-clinical investigations. However, gauging the extent to which these (and other) approaches inhibit the development of PTOA in the knee joint is often overlooked, yet an important consideration for determining the overall efficacy of potential treatments. In this review, we catalog recent advancements in pre-clinical therapies for meniscus injuries and discuss the assessment methodologies that are used for gauging the success of these treatments based on their effect on PTOA severity. Methodologies include histopathological evaluation of cartilage, radiographic evaluation of the knee, analysis of knee function, and quantification of OA predictive biomarkers. Lastly, we analyze the prevalence of these methodologies using a systemic PubMed® search for original scientific journal articles published in the last 3-years. We indexed 37 meniscus repair/replacement studies conducted in live animal models. Overall, our findings show that approximately 75% of these studies have performed at least one assessment for PTOA following meniscus injury repair. Out of this, 84% studies have reported an improvement in PTOA resulting from treatment.

Biosynthetic scaffolds for partial meniscal loss: A systematic review from animal models to clinical practice

Acute or degenerative meniscus tears are the most common knee lesions. Meniscectomy provides symptomatic relief and functional recovery only in the short- to mid-term follow-up but significantly increases the risk of osteoarthritis. For this reason, preserving the meniscus is key, although it remains a challenge. Allograft transplants present many disadvantages, so during the last 20 years preclinical and clinical research focused on developing and investigating meniscal scaffolds. The aim of this systematic review was to collect and evaluate all the available evidence on biosynthetic scaffolds for meniscus regeneration both in vivo and in clinical studies. Three databases were searched: 46 in vivo preclinical studies and 30 clinical ones were found. Sixteen natural, 15 synthetic, and 15 hybrid scaffolds were studied in vivo. Among them, only 2 were translated into clinic: the Collagen Meniscus Implant, used in 11 studies, and the polyurethane-based scaffold Actifit®, applied in 19 studies. Although positive outcomes were described in the short- to mid-term, the number of concurrent procedures and the lack of randomized trials are the major limitations of the available clinical literature. Few in vivo studies also combined the use of cells or growth factors, but these augmentation strategies have not been applied in the clinical practice yet. Current solutions offer a significant but incomplete clinical improvement, and the regeneration potential is still unsatisfactory. Building upon the overall positive results of these "old" technologies to address partial meniscal loss, further innovation is urgently needed in this field to provide patients better joint sparing treatment options.

Production of bacterial cellulose using Gluconacetobacter kombuchae immobilized on Luffa aegyptiaca support

The present work report for the first time on the production of bacterial cellulose (BC) using natural loofa sponge (Luffa aegyptiaca) as a scaffold for the immobilization of Gluconacetobacter kombuchae. Bacterial cellulose (BC) are recently gained more attention in several fields including biological and biomedical applications due to their outstanding physico-chemical characteristics including high thermal stability, easy biodegradability, good water holding capacity, high tensile strength, and high degree of polymerization. The increase in requirement of alternative method for the enhancement of BC production under economical aspect develops a positive impact in large scale industries. In this study, Luffa aegyptiaca (LA) was introduced in a separate fermentation medium so as to enhance the concentration of BC production by Gluconacetobacter kombuchae. Different process/medium parameters such as initial pH, static/shaking condition, inoculum size, nitrogen source, C/N ratio, supplements (ethanol and acetic acid) were analysed for the production of bacterial cellulose using LA support. The maximum yield of BC was obtained using following condition: culturing condition -shaking; initial pH - 5.5; nitrogen source- yeast extract, C/N ratio - 40 and supplement-ethanol. The characterization of the BC was examined using Fourier Transform Infra-Red spectroscopy and thermo gravimetric analysis. The biofilm formation on the surface of LA was examined by SEM photographs. Thus, implementation of LA as a support in shaking fermentation under suitable medium/process variables enhanced the BC production.

Dendritic cell biocompatibility of ether-based urethane films

The use of synthetic materials for biomedical applications is ever expanding. One of the major requirements for these materials is biocompatibility, which includes prevention of immune system responses. Due to the inherent complexity of their structural composition, the polyurethane (PU) family of polymers is being used in a variety of medical applications, from soft and hard tissue scaffolds to intricate coatings on implantable devices. Herein, we investigated whether two polymer materials, D3 and D7, induced an immune response, measured by their effects on a dendritic cell (DC) line, JAWS II. Using a lactate dehydrogenase cytotoxicity assay and Annexin V/PI staining, we found that the PU materials did not induce cytotoxicity in DC cells. Using confocal microscopy, we also showed that the materials did not induce activation or maturation, as compared to positive controls. This was confirmed by looking at various markers, CD80, CD86, MHC class I, and MHC class II, via flow cytometry. Overall, the results indicated that the investigated PU films are biocompatible in terms of immunotoxicology and immunogenicity and show great promise for use in regenerative medicine.