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Al-Namnam NM, Luczak AT, Yang I, Li X, Lucas M, Hall AC, Simpson AHR. Chondroprotection of articular cartilage integrity: Utilizing ultrasonic scalpel and hyperosmolar irrigation solution during cutting. OSTEOARTHRITIS AND CARTILAGE OPEN 2024; 6:100499. [PMID: 39076683 PMCID: PMC11284703 DOI: 10.1016/j.ocarto.2024.100499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 06/25/2024] [Indexed: 07/31/2024] Open
Abstract
Objectives Ultrasonic (US) cutting of cartilage in orthopaedic surgery has received little attention despite its potential to reduce chondrocyte death which could enhance cartilage repair. We aimed to investigate whether an ultrasonically-vibrating scalpel to cut human articular cartilage could reduce chondrocyte death, and to determine if hyper-osmolarity could provide chondroprotection during the procedure. Methods A scalpel (no. 15) was mounted on an ultrasonic transducer to resonate at 35 kHz with 30 μm vibrational displacement. Thirty-six fresh human femoral cartilage samples were divided into four groups based on ultrasonic activation (US or non-US) and saline osmolarity (300 or 600 mOsm/L). Cell viability was assessed using a live/dead cell assay and analysed quantitatively by confocal microscopy. Histology illustrated tissue surface changes at the cut site. Results The overall chondrocyte death percentage at both the US and non-US cut sites showed comparable results (p > 0.05) in both osmolarities. However, the zone of chondrocyte death was reduced by 31 ± 5% and 36 ± 6%, respectively, when comparing US cutting at 300 mOsm/L and 600 mOsm/L to the control group (non-US cutting; 300 mOsm/L) (p < 0.05). The width of the cut was consistent at both sites, regardless of the method of cutting. Conclusion Cutting human cartilage with US in the presence of 300 or 600 mOsm/L media was chondroprotective compared to normal (non-US) scalpel cutting in 300 mOsm/L medium. These results suggest chondroprotection can be achieved while cutting using a US scalpel and raised osmolarity, potentially improving cartilage regeneration and repair following injury.
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Affiliation(s)
| | - Aneta T. Luczak
- Department of Orthopaedics and Trauma, University of Edinburgh, Edinburgh, UK
| | - Irene Yang
- Department of Orthopaedics and Trauma, University of Edinburgh, Edinburgh, UK
| | - Xuan Li
- James Watt School of Engineering, University of Glasgow, Glasgow, UK
| | - Margaret Lucas
- James Watt School of Engineering, University of Glasgow, Glasgow, UK
| | - Andrew C. Hall
- Deanery of Biomedical Sciences, University of Edinburgh, Edinburgh, UK
| | - A. Hamish R.W. Simpson
- Department of Orthopaedics and Trauma, University of Edinburgh, Edinburgh, UK
- Royal Infirmary of Edinburgh, Edinburgh, UK
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Merrild NG, Holzmann V, Ariosa-Morejon Y, Faull PA, Coleman J, Barrell WB, Young G, Fischer R, Kelly DJ, Addison O, Vincent TL, Grigoriadis AE, Gentleman E. Local depletion of proteoglycans mediates cartilage tissue repair in an ex vivo integration model. Acta Biomater 2022; 149:179-188. [PMID: 35779773 DOI: 10.1016/j.actbio.2022.06.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 05/25/2022] [Accepted: 06/17/2022] [Indexed: 11/28/2022]
Abstract
Successfully replacing damaged cartilage with tissue-engineered constructs requires integration with the host tissue and could benefit from leveraging the native tissue's intrinsic healing capacity; however, efforts are limited by a poor understanding of how cartilage repairs minor defects. Here, we investigated the conditions that foster natural cartilage tissue repair to identify strategies that might be exploited to enhance the integration of engineered/grafted cartilage with host tissue. We damaged porcine articular cartilage explants and using a combination of pulsed SILAC-based proteomics, ultrastructural imaging, and catabolic enzyme blocking strategies reveal that integration of damaged cartilage surfaces is not driven by neo-matrix synthesis, but rather local depletion of proteoglycans. ADAMTS4 expression and activity are upregulated in injured cartilage explants, but integration could be reduced by inhibiting metalloproteinase activity with TIMP3. These observations suggest that catabolic enzyme-mediated proteoglycan depletion likely allows existing collagen fibrils to undergo cross-linking, fibrillogenesis, or entanglement, driving integration. Catabolic enzymes are often considered pathophysiological markers of osteoarthritis. Our findings suggest that damage-induced upregulation of metalloproteinase activity may be a part of a healing response that tips towards tissue destruction under pathological conditions and in osteoarthritis, but could also be harnessed in tissue engineering strategies to mediate repair. STATEMENT OF SIGNIFICANCE: Cartilage tissue engineering strategies require graft integration with the surrounding tissue; however, how the native tissue repairs minor injuries is poorly understood. We applied pulsed SILAC-based proteomics, ultrastructural imaging, and catabolic enzyme blocking strategies to a porcine cartilage explant model and found that integration of damaged cartilage surfaces is driven by catabolic enzyme-mediated local depletion of proteoglycans. Although catabolic enzymes have been implicated in cartilage destruction in osteoarthritis, our findings suggest that damage-induced upregulation of metalloproteinase activity may be a part of a healing response that tips towards tissue destruction under pathological conditions. They also suggest that this natural cartilage tissue repair process could be harnessed in tissue engineering strategies to enhance the integration of engineered cartilage with host tissue.
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Affiliation(s)
- Nicholas Groth Merrild
- Centre for Craniofacial and Regenerative Biology, King's College London, London SE1 9RT, UK
| | - Viktoria Holzmann
- Centre for Craniofacial and Regenerative Biology, King's College London, London SE1 9RT, UK
| | - Yoanna Ariosa-Morejon
- Centre for OA Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, University of Oxford, Oxford OX3 7FY, UK
| | - Peter A Faull
- College of Pharmacy, University of Texas at Austin, Austin, TX 78712, USA
| | - Jennifer Coleman
- Centre for Craniofacial and Regenerative Biology, King's College London, London SE1 9RT, UK
| | - William B Barrell
- Centre for Craniofacial and Regenerative Biology, King's College London, London SE1 9RT, UK
| | - Gloria Young
- Department of Materials, Imperial College London, London SW7 2AZ, UK
| | - Roman Fischer
- Target Discovery Institute, Nuffield Department of Medicine, University of Oxford, Oxford OX3 7FZ, UK
| | - Daniel J Kelly
- Trinity Centre for Biomedical Engineering, Trinity College Dublin, Dublin 2, Ireland
| | - Owen Addison
- Centre for Oral, Clinical and Translational Sciences, King's College London, London SE1 9RT, UK
| | - Tonia L Vincent
- Centre for OA Pathogenesis Versus Arthritis, Kennedy Institute of Rheumatology, University of Oxford, Oxford OX3 7FY, UK
| | | | - Eileen Gentleman
- Centre for Craniofacial and Regenerative Biology, King's College London, London SE1 9RT, UK.
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3
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Shiromoto Y, Niki Y, Kikuchi T, Yoshihara Y, Oguma T, Nemoto K, Chiba K, Kanaji A, Matsumoto M, Nakamura M. Increased migratory activity and cartilage regeneration by superficial-zone chondrocytes in enzymatically treated cartilage explants. BMC Musculoskelet Disord 2022; 23:256. [PMID: 35296296 PMCID: PMC8925221 DOI: 10.1186/s12891-022-05210-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 03/07/2022] [Indexed: 12/02/2022] Open
Abstract
Background Limited chondrocyte migration and impaired cartilage-to-cartilage healing is a barrier in cartilage regenerative therapy. Collagenase treatment and delivery of a chemotactic agent may play a positive role in chondrocyte repopulation at the site of cartilage damage. This study evaluated chondrocyte migratory activity after enzymatic treatment in cultured cartilage explant. Differential effects of platelet-derived growth factor (PDGF) dimeric isoforms on the migratory activity were investigated to define major chemotactic factors for cartilage. Methods Full-thickness cartilage (4-mm3 blocks) were harvested from porcine femoral condyles and subjected to explant culture. After 15 min or 60 min of actinase and collagenase treatments, chondrocyte migration and infiltration into a 0.5-mm cartilage gap was investigated. Cell morphology and lubricin, keratan sulfate, and chondroitin 4 sulfate expression in superficial- and deep-zone chondrocytes were assessed. The chemotactic activities of PDGF-AA, −AB, and -BB were measured in each zone of chondrocytes, using a modified Boyden chamber assay. The protein and mRNA expression and histological localization of PDGF-β were analyzed by western blot analysis, real-time reverse transcription polymerase chain reaction (RT-PCR), and immunohistochemistry, and results in each cartilage zone were compared. Results Superficial-zone chondrocytes had higher migratory activity than deep-zone chondrocytes and actively bridged the cartilage gap, while metachromatic staining by toluidine blue and immunoreactivities of keratan sulfate and chondroitin 4 sulfate were detected around the cells migrating from the superficial zone. These superficial-zone cells with weak immunoreactivity for lubricin tended to enter the cartilage gap and possessed higher migratory activity, while the deep-zone chondrocytes remained in the lacuna and exhibited less migratory activity. Among PDGF isoforms, PDGF-AB maximized the degree of chemotactic activity of superficial zone chondrocytes. Increased expression of PDGF receptor-β was associated with higher migratory activity of the superficial-zone chondrocytes. Conclusions In enzymatically treated cartilage explant culture, chondrocyte migration and infiltration into the cartilage gap was higher in the superficial zone than in the deep zone. Preferential expression of PDGF receptor-β combined with the PDGF-AB dimeric isoform may explain the increased migratory activity of the superficial-zone chondrocytes. Cells migrating from superficial zone may contribute to cartilage regeneration. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05210-2.
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Affiliation(s)
- Yuichiro Shiromoto
- Department of Orthopedic Surgery, School of Medicine, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan.,Department of Orthopedic Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa City, Saitama, 359-8513, Japan
| | - Yasuo Niki
- Department of Orthopedic Surgery, School of Medicine, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Toshiyuki Kikuchi
- Department of Orthopedic Surgery, National Hospital Organization, Murayama Medical Center, 2-37-1 Gakuen, Musashimurayama City, Tokyo, 208-0011, Japan
| | - Yasuo Yoshihara
- Department of Orthopedic Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa City, Saitama, 359-8513, Japan.,Department of Orthopedic Surgery, National Hospital Organization, Murayama Medical Center, 2-37-1 Gakuen, Musashimurayama City, Tokyo, 208-0011, Japan
| | - Takemi Oguma
- Department of Orthopedic Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa City, Saitama, 359-8513, Japan
| | - Koichi Nemoto
- Department of Orthopedic Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa City, Saitama, 359-8513, Japan
| | - Kazuhiro Chiba
- Department of Orthopedic Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa City, Saitama, 359-8513, Japan
| | - Arihiko Kanaji
- Department of Orthopedic Surgery, School of Medicine, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Morio Matsumoto
- Department of Orthopedic Surgery, School of Medicine, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Masaya Nakamura
- Department of Orthopedic Surgery, School of Medicine, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan
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New Insights into Cartilage Tissue Engineering: Improvement of Tissue-Scaffold Integration to Enhance Cartilage Regeneration. BIOMED RESEARCH INTERNATIONAL 2022; 2022:7638245. [PMID: 35118158 PMCID: PMC8807044 DOI: 10.1155/2022/7638245] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 12/20/2021] [Accepted: 12/29/2021] [Indexed: 02/05/2023]
Abstract
Distinctive characteristics of articular cartilage such as avascularity and low chondrocyte conversion rate present numerous challenges for orthopedists. Tissue engineering is a novel approach that ameliorates the regeneration process by exploiting the potential of cells, biodegradable materials, and growth factors. However, problems exist with the use of tissue-engineered construct, the most important of which is scaffold-cartilage integration. Recently, many attempts have been made to address this challenge via manipulation of cellular, material, and biomolecular composition of engineered tissue. Hence, in this review, we highlight strategies that facilitate cartilage-scaffold integration. Recent advances in where efficient integration between a scaffold and native cartilage could be achieved are emphasized, in addition to the positive aspects and remaining problems that will drive future research.
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Trengove A, Di Bella C, O'Connor AJ. The Challenge of Cartilage Integration: Understanding a Major Barrier to Chondral Repair. TISSUE ENGINEERING PART B-REVIEWS 2021; 28:114-128. [PMID: 33307976 DOI: 10.1089/ten.teb.2020.0244] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Articular cartilage defects caused by injury frequently lead to osteoarthritis, a painful and costly disease. Despite widely used surgical methods to treat articular cartilage defects and a plethora of research into regenerative strategies as treatments, long-term clinical outcomes are not satisfactory. Failure to integrate repair tissue with native cartilage is a recurring issue in surgical and tissue-engineered strategies, seeing eventual degradation of the regenerated or surrounding tissue. This review delves into the current understanding of why continuous and robust integration with native cartilage is so difficult to achieve. Both the intrinsic limitations of chondrocytes to remodel injured cartilage, and the significant challenges posed by a compromised biomechanical environment are described. Recent scaffold and cell-based techniques to repair cartilage are also discussed, and limitations of existing methods to evaluate integrative repair. In particular, the importance of evaluating the mechanical integrity of the interface between native and repair tissue is highlighted as a meaningful assessment of any strategy to repair this load-bearing tissue. Impact statement The failure to integrate grafts or biomaterials with native cartilage is a major barrier to cartilage repair. An in-depth understanding of the reasons cartilage integration remains a challenge is required to inform cartilage repair strategies. In particular, this review highlights that integration of cartilage repair strategies is frequently assessed in terms of the continuity of tissue, but not the mechanical integrity. Given the load-bearing nature of cartilage, evaluating integration in terms of interfacial strength is essential to assessing the potential success of cartilage repair methods.
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Affiliation(s)
- Anna Trengove
- Department of Biomedical Engineering, The University of Melbourne, Melbourne, Australia
| | - Claudia Di Bella
- Department of Surgery, St. Vincent's Hospital, The University of Melbourne, Melbourne, Australia.,Department of Orthopedics, St. Vincent's Hospital Melbourne, Melbourne, Australia
| | - Andrea J O'Connor
- Department of Biomedical Engineering, The University of Melbourne, Melbourne, Australia
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Is There a Scientific Rationale for the Refixation of Delaminated Chondral Flaps in Femoroacetabular Impingement? A Laboratory Study. Clin Orthop Relat Res 2020; 478:854-867. [PMID: 32011382 PMCID: PMC7282577 DOI: 10.1097/corr.0000000000001135] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Debonding of the acetabular cartilage is a characteristic type of hip damage found in cam-type femoroacetabular impingement (FAI), which remains a treatment challenge. In addition to resection, refixation of these flaps using fibrin sealants has been recently suggested. However, there is only limited evidence available that the proposed refixation method results in sufficient viable cartilage formation to ensure long-term flap grafting and restored tissue function. QUESTIONS/PURPOSES To determine the flap tissue characteristics that would justify refixation of delaminated chondral flaps with a fibrin sealant, we characterized (1) the extracellular matrix (ECM) of chondral flaps in terms of chondrocyte viability and distribution of ECM components and (2) the chondrogenic potential of resident cells to migrate into fibrin and produce a cartilaginous matrix. METHODS Ten acetabular chondral flaps and three non-delaminated control cartilage samples were resected during surgery. Chondrocyte viability was quantified using a live-dead assay. To assess the ECM, histological staining of glycosaminoglycans, collagen II, and collagen I allowed the qualitative study of their distribution. The ability of chondrocytes to migrate out of the ECM was tested by encapsulating minced flap cartilage in fibrin gels and semi-quantitatively assessing the projected area of the gel covered with migrating cells. The potential of chondrocytes to produce a cartilaginous matrix was studied with a pellet assay, a standard three-dimensional culture system to test chondrogenesis. Positive controls were pellets of knee chondrocytes of age-matched donors, which we found in a previous study to have a good capacity to produce cartilage matrix. Statistical significance of controlled quantitative assays was determined by the Student's t-test with Welch's correction. RESULTS The proportion of viable chondrocytes in flaps was lower than in nondelaminated cartilage (50% ± 19% versus 76 ± 6%; p = 0.02). Histology showed a disrupted ECM in flaps compared with nondelaminated controls, with the presence of fibrillation, a loss of glycosaminoglycan at the delaminated edge, collagen II throughout the whole thickness of the flap, and some collagen I-positive area in two samples. The resident chondrocytes migrated out of this disrupted ECM in all tested samples. However in pellet culture, cells isolated from the flaps showed a qualitatively lower chondrogenic potential compared with positive controls, with a clearly inhomogeneous cell and matrix distribution and an overall smaller projected area (0.4 versus 0.7 mm; p = 0.038). CONCLUSION Despite the presence of viable chondrocytes with migration potential, the cells resided in a structurally altered ECM and had limited capacity to deposit ECM, leading us to question their capacity to produce sufficient ECM within the fibrin sealant for stable long-term attachment of such flaps. CLINICAL RELEVANCE The characterization of delaminated cartilage in cam FAI patients suggests that the refixation strategy might be adversely influenced by the low level of ECM produced by the residing cells.
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Sahu N, Miller A, Viljoen HJ, Subramanian A. Continuous Low-Intensity Ultrasound Promotes Native-to-Native Cartilage Integration. Tissue Eng Part A 2019; 25:1538-1549. [PMID: 31190618 DOI: 10.1089/ten.tea.2018.0355] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Failure of the host/graft interface to integrate impedes the success of cartilage repair protocols. Continuous low-intensity ultrasound (cLIUS) at the resonant frequency of 5 MHz is proposed as a treatment modality for promoting native-to-native cartilage integration in vitro. Cylindrical incisions (4 mm) simulating chondral discontinuity were made in bovine cartilage and osteochondral explants, and maintained under cLIUS stimulation (14 kPa [5 MHz, 2.5 Vpp], 20 min, four times/day) for 28 days. Incised cartilage and osteochondral explants were categorized into three study groups; Group I: cLIUS was applied immediately upon incision; Group II: cLIUS was applied after 14 days following incision; Group-III: after 14 days following incision, explants were treated with 0.1% hyaluronidase and 30 U/mL collagenase VII. As a separate study group, incised osteochondral explants were treated immediately with cLIUS at a nonresonant frequency of 2 MHz (14 kPa [2 MHz, 6 Vpp], 20 min, four times/day). Cellular migration was analyzed by scratch assays, and by visualizing migrating cells into the hydrogel core of cartilage/hydrogel constructs. Explants under cLIUS (5 MHz) displayed higher percent apposition along with gap closures when compared with untreated controls and explants treated with cLIUS at 2 MHz. cLIUS (5 MHz)-treated explants were immunopositive for type II collagen. The strength of native-to-native cartilage integration was higher (p = 0.005) in cLIUS-treated cartilage explants at 0.19 ± 0.08 MPa as compared with 0.05 ± 0.03 MPa in untreated controls. Enhanced cartilage phenotype coupled with increased cellular migration were noted under cLIUS (5 MHz), alluding to the observed integration between cartilage interfaces. Collectively, cLIUS at cell resonant frequency promoted integrative cartilage repair, therefore, has the potential to improve cartilage repair outcomes. Impact Statement Lack of integration between the host and graft cartilage interfaces impedes the success of cartilage repair techniques. Continuous low-intensity ultrasound (cLIUS) is documented to induce chondrogenesis and chondrocyte phenotype. However, integrative cartilage repair under cLIUS has not been evaluated. Our results demonstrated integration between cartilage interfaces, increased percent apposition, increased strength of integration, and maintenance of cartilage phenotype under cLIUS (5 MHz). Integrative repair under cLIUS (5 MHz) stemmed from enhanced migration of cells and increased expression of cartilage-specific genes, namely SOX9 and COL2A1. Thus, cLIUS has the potential to improve the outcomes of grafting protocols for cartilage repair.
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Affiliation(s)
- Neety Sahu
- Department of Chemical and Biomolecular Engineering, University of Nebraska-Lincoln, Lincoln, Nebraska
| | - April Miller
- Department of Chemistry and Life Science, United States Military Academy, West Point, New York
| | - Hendrik J Viljoen
- Department of Chemical and Biomolecular Engineering, University of Nebraska-Lincoln, Lincoln, Nebraska
| | - Anuradha Subramanian
- Department of Chemical and Materials Engineering, The University of Alabama in Huntsville, Huntsville, Alabama
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Sahu N, Viljoen HJ, Subramanian A. Continuous low-intensity ultrasound attenuates IL-6 and TNFα-induced catabolic effects and repairs chondral fissures in bovine osteochondral explants. BMC Musculoskelet Disord 2019; 20:193. [PMID: 31054572 PMCID: PMC6499975 DOI: 10.1186/s12891-019-2566-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 04/11/2019] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Cartilage repair outcomes are compromised in a pro-inflammatory environment; therefore, the mitigation of pro-inflammatory responses is beneficial. Treatment with continuous low-intensity ultrasound (cLIUS) at the resonant frequency of 5 MHz is proposed for the repair of chondral fissures under pro-inflammatory conditions. METHODS Bovine osteochondral explants, concentrically incised to create chondral fissures, were maintained under cLIUS (14 kPa (5 MHz, 2.5 Vpp), 20 min, 4 times/day) for a period of 28 days in the presence or absence of cytokines, interleukin-6 (IL-6) or tumor necrosis factor (TNF)α. Outcome assessments included histological and immunohistochemical staining of the explants; and the expression of catabolic and anabolic genes by qRT-PCR in bovine chondrocytes. Cell migration was assessed by scratch assays, and by visualizing migrating cells into the hydrogel core of cartilage-hydrogel constructs. RESULTS Both in the presence and absence of cytokines, higher percent apposition along with closure of fissures were noted in cLIUS-stimulated explants as compared to non-cLIUS-stimulated explants on day 14. On day 28, the percent apposition was not significantly different between unstimulated and cLIUS-stimulated explants exposed to cytokines. As compared to non-cLIUS-stimulated controls, on day 28, cLIUS preserved the distribution of proteoglycans and collagen II in explants despite exposure to cytokines. cLIUS enhanced the cell migration irrespective of cytokine treatment. IL-6 or TNFα-induced increases in MMP13 and ADAMTS4 gene expression was rescued by cLIUS stimulation in chondrocytes. Under cLIUS, TNFα-induced increase in NF-κB expression was suppressed, and the expression of collagen II and TIMP1 genes were upregulated. CONCLUSION cLIUS repaired chondral fissures, and elicited pro-anabolic and anti-catabolic effects, thus demonstrating the potential of cLIUS in improving cartilage repair outcomes.
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Affiliation(s)
- Neety Sahu
- Department of Chemical and Biomolecular Engineering, University of Nebraska-Lincoln, Lincoln, NE, 68588-0643, USA
| | - Hendrik J Viljoen
- Department of Chemical and Biomolecular Engineering, University of Nebraska-Lincoln, Lincoln, NE, 68588-0643, USA
| | - Anuradha Subramanian
- Department of Chemical and Materials Engineering, University of Alabama at Huntsville, Huntsville, Alabama, 35899, USA.
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Boushell MK, Mosher CZ, Suri GK, Doty SB, Strauss EJ, Hunziker EB, Lu HH. Polymeric mesh and insulin-like growth factor 1 delivery enhance cell homing and graft-cartilage integration. Ann N Y Acad Sci 2019; 1442:138-152. [PMID: 30985969 PMCID: PMC7596880 DOI: 10.1111/nyas.14054] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 02/13/2019] [Accepted: 02/22/2019] [Indexed: 01/05/2023]
Abstract
Cartilage injury, such as full-thickness lesions, predisposes patients to the premature development of osteoarthritis, a degenerative joint disease. While surgical management of cartilage lesions has improved, long-term clinical efficacy has stagnated, owing to the lack of hyaline cartilage regeneration and inadequate graft-host integration. This study tests the hypothesis that integration of cartilage grafts with native cartilage can be improved by enhancing the migration of chondrocytes across the graft-host interface via the release of chemotactic factor from a degradable polymeric mesh. To this end, a polylactide-co-glycolide/poly-ε-caprolactone mesh was designed to localize the delivery of insulin-like growth factor 1 (IGF-1), a well-established chondrocyte attractant. The release of IGF-1 (100 ng/mg) enhanced cell migration from cartilage explants, and the mesh served as critical structural support for cell adhesion, growth, and production of a cartilaginous matrix in vitro, which resulted in increased integration strength compared with mesh-free repair. Further, this neocartilage matrix was structurally contiguous with native and grafted cartilage when tested in an osteochondral explant model in vivo. These results demonstrate that this combined approach of a cell homing factor and supportive matrix will promote cell-mediated integrative cartilage repair and improve clinical outcomes of cartilage grafts in the treatment of osteoarthritis.
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Affiliation(s)
- Margaret K. Boushell
- Biomaterials and Interface Tissue Engineering Laboratory, Department of Biomedical Engineering, Columbia University, New York, New York
| | | | - Gurbani K. Suri
- Biomaterials and Interface Tissue Engineering Laboratory, Department of Biomedical Engineering, Columbia University, New York, New York
| | - Stephen B. Doty
- Analytical Microscopy Laboratory, Hospital for Special Surgery, New York, New York
| | - Eric J. Strauss
- Department of Orthopaedic Surgery, NYU Langone Medical Center, New York, New York
| | - Ernst B. Hunziker
- Department of BioMedical Research, University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Helen H. Lu
- Biomaterials and Interface Tissue Engineering Laboratory, Department of Biomedical Engineering, Columbia University, New York, New York
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Vainieri M, Wahl D, Alini M, van Osch G, Grad S. Mechanically stimulated osteochondral organ culture for evaluation of biomaterials in cartilage repair studies. Acta Biomater 2018; 81:256-266. [PMID: 30273741 DOI: 10.1016/j.actbio.2018.09.058] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 08/15/2018] [Accepted: 09/27/2018] [Indexed: 10/28/2022]
Abstract
Surgical procedures such as microfracture or autologous chondrocyte implantation have been used to treat articular cartilage lesions; however, repair often fails in terms of matrix organization and mechanical behaviour. Advanced biomaterials and tissue engineered constructs have been developed to improve cartilage repair; nevertheless, their clinical translation has been hampered by the lack of reliable in vitro models suitable for pre-clinical screening of new implants and compounds. In this study, an osteochondral defect model in a bioreactor that mimics the multi-axial motion of an articulating joint, was developed. Osteochondral explants were obtained from bovine stifle joints, and cartilage defects of 4 mm diameter were created. The explants were used as an interface against a ceramic ball applying dynamic compressive and shear loading. Osteochondral defects were filled with chondrocytes-seeded fibrin-polyurethane constructs and subjected to mechanical stimulation. Cartilage viability, proteoglycan accumulation and gene expression of seeded chondrocytes were compared to free swelling controls. Cells within both cartilage and bone remained viable throughout the 10-day culture period. Loading did not wear the cartilage, as indicated by histological evaluation and glycosaminoglycan release. The gene expression of seeded chondrocytes indicated a chondrogenic response to the mechanical stimulation. Proteoglycan 4 and cartilage oligomeric matrix protein were markedly increased, while mRNA ratios of collagen type II to type I and aggrecan to versican were also enhanced. This mechanically stimulated osteochondral defect culture model provides a viable microenvironment and will be a useful pre-clinical tool to screen new biomaterials and biological regenerative therapies under relevant complex mechanical stimuli. STATEMENT OF SIGNIFICANCE: Articular cartilage lesions have a poor healing capacity and reflect one of the most challenging problems in orthopedic clinical practice. The aim of current research is to develop a testing system to assess biomaterials for implants, that can permanently replace damaged cartilage with the original hyaline structure and can withstand the mechanical forces long term. Here, we present an osteochondral ex vivo culture model within a cartilage bioreactor, which mimics the complex motion of an articulating joint in vivo. The implementation of mechanical forces is essential for pre-clinical testing of novel technologies in the field of cartilage repair, biomaterial engineering and regenerative medicine. Our model provides a unique opportunity to investigate healing of articular cartilage defects in a physiological joint-like environment.
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11
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Yu C, Liu J, Lu G, Xie Y, Sun Y, Wang Q, Liang J, Fan Y, Zhang X. Repair of osteochondral defects in a rabbit model with artificial cartilage particulates derived from cultured collagen-chondrocyte microspheres. J Mater Chem B 2018; 6:5164-5173. [DOI: 10.1039/c8tb01185k] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Sketch of fabrication, filling up and repair of rabbit osteochondral defects using artificial cartilage particulates (ACPs) based on collagen I hydrogel microspheres with chondrocytes.
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Affiliation(s)
- Cheng Yu
- National Engineering Research Center for Biomaterials, Sichuan University
- Chengdu 610064
- China
| | - Jun Liu
- National Engineering Research Center for Biomaterials, Sichuan University
- Chengdu 610064
- China
| | - Gonggong Lu
- National Engineering Research Center for Biomaterials, Sichuan University
- Chengdu 610064
- China
| | - Yuxing Xie
- National Engineering Research Center for Biomaterials, Sichuan University
- Chengdu 610064
- China
| | - Yong Sun
- National Engineering Research Center for Biomaterials, Sichuan University
- Chengdu 610064
- China
| | - Qiguang Wang
- National Engineering Research Center for Biomaterials, Sichuan University
- Chengdu 610064
- China
| | - Jie Liang
- National Engineering Research Center for Biomaterials, Sichuan University
- Chengdu 610064
- China
| | - Yujiang Fan
- National Engineering Research Center for Biomaterials, Sichuan University
- Chengdu 610064
- China
| | - Xingdong Zhang
- National Engineering Research Center for Biomaterials, Sichuan University
- Chengdu 610064
- China
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12
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Abstract
Osteoarthritis (OA) is a degenerative joint condition characterized by painful cartilage lesions that impair joint mobility. Current treatments such as lavage, microfracture, and osteochondral implantation fail to integrate newly formed tissue with host tissues and establish a stable transition to subchondral bone. Similarly, tissue-engineered grafts that facilitate cartilage and bone regeneration are challenged by how to integrate the graft seamlessly with surrounding host cartilage and/or bone. This review centers on current approaches to promote cartilage graft integration. It begins with an overview of articular cartilage structure and function, as well as degenerative changes to this relationship attributed to aging, disease, and trauma. A discussion of the current progress in integrative cartilage repair follows, focusing on graft or scaffold design strategies targeting cartilage-cartilage and/or cartilage-bone integration. It is emphasized that integrative repair is required to ensure long-term success of the cartilage graft and preserve the integrity of the newly engineered articular cartilage. Studies involving the use of enzymes, choice of cell source, biomaterial selection, growth factor incorporation, and stratified versus gradient scaffolds are therefore highlighted. Moreover, models that accurately evaluate the ability of cartilage grafts to enhance tissue integrity and prevent ectopic calcification are also discussed. A summary and future directions section concludes the review.
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Affiliation(s)
- Margaret K Boushell
- a Biomaterials and Interface Tissue Engineering Laboratory, Department of Biomedical Engineering , Columbia University , New York , NY , USA
| | - Clark T Hung
- b Cellular Engineering Laboratory , Department of Biomedical Engineering Columbia University , New York , NY , USA
| | - Ernst B Hunziker
- c Department of Orthopaedic Surgery & Department of Clinical Research, Center of Regenerative Medicine for Skeletal Tissues , University of Bern , Bern , Switzerland
| | - Eric J Strauss
- d Department of Orthopaedic Surgery, Langone Medical Center , New York University , New York , NY , USA
| | - Helen H Lu
- a Biomaterials and Interface Tissue Engineering Laboratory, Department of Biomedical Engineering , Columbia University , New York , NY , USA
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13
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Dikina AD, Almeida HV, Cao M, Kelly DJ, Alsberg E. Scaffolds Derived from ECM Produced by Chondrogenically Induced Human MSC Condensates Support Human MSC Chondrogenesis. ACS Biomater Sci Eng 2017; 3:1426-1436. [DOI: 10.1021/acsbiomaterials.6b00654] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Anna D. Dikina
- Department
of Biomedical Engineering, Case Western Reserve University, 10900
Euclid Avenue, Cleveland, Ohio 44106, United States
| | - Henrique V. Almeida
- Trinity
Centre for Bioengineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, 152-160 Pearse Street, Dublin
2, Ireland
- Department
of Mechanical and Manufacturing Engineering, School of Engineering, Trinity College Dublin, College Green, Dublin 2, Ireland
| | - Meng Cao
- Department
of Biomedical Engineering, Case Western Reserve University, 10900
Euclid Avenue, Cleveland, Ohio 44106, United States
| | - Daniel J. Kelly
- Trinity
Centre for Bioengineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, 152-160 Pearse Street, Dublin
2, Ireland
- Department
of Mechanical and Manufacturing Engineering, School of Engineering, Trinity College Dublin, College Green, Dublin 2, Ireland
- Tissue
Engineering Research Group, Department of Anatomy, Royal College of Surgeons in Ireland, 123 St. Stephen’s Green, Dublin 2, Ireland
- Advanced Materials and Bioengineering Research Centre (AMBER), Trinity College Dublin & Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Eben Alsberg
- Department
of Biomedical Engineering, Case Western Reserve University, 10900
Euclid Avenue, Cleveland, Ohio 44106, United States
- Orthopaedic
Surgery, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, United States
- The
National Center for Regenerative Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106, United States
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14
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Gittens J, Haleem AM, Grenier S, Smyth NA, Hannon CP, Ross KA, Torzilli PA, Kennedy JG. Use of novel chitosan hydrogels for chemical tissue bonding of autologous chondral transplants. J Orthop Res 2016; 34:1139-46. [PMID: 26698186 DOI: 10.1002/jor.23142] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 12/08/2015] [Indexed: 02/04/2023]
Abstract
The objective of this study was to evaluate the effect of chemical tissue bonding (CTB) on adhesion strength, fluid permeability, and cell viability across a cartilaginous graft-host interface in an in vitro autologous chondral transplant (ACT) model. Chitosan-based cross-linkers; Chitosan-Rose Bengal [Chi-RB (Ch-ABC)], Chitosan-Genipin [Chi-GP (Ch-ABC)], and Chitosan-Rose Bengal-Genipin [Chi-RB-GP (Ch-ABC)] were applied to bovine immature cartilage explants after pre-treatment with surface degrading enzyme, Chondroitinase-ABC (Ch-ABC). Adhesion strength, fluid permeability and cell viability were assessed via mechanical push-out shear testing, fluid transport and live/dead cell staining, respectively. All three chitosan-based cross-linkers significantly increased the adhesion strength at the graft-host interface, however, only a statistically significant decrease in fluid permeability was noted in Chi-GP (Ch-ABC) specimen compared to untreated controls. Cell viability was maintained for 7 days of culture across all three treatment groups. These results show the potential clinical relevance of novel chitosan-based hydrogels in enhancing tissue integration and reducing synovial fluid penetration after ACT procedures in diarthoidal joints such as the knee and ankle. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1139-1146, 2016.
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Affiliation(s)
- Jamila Gittens
- Laboratory for Soft Tissue Research, Hospital for Special Surgery, New York, New York
| | - Amgad M Haleem
- Department of Orthopedic Surgery, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma.,Department of Orthopedic Surgery, Cairo University School of Medicine, Cairo, Egypt
| | - Stephanie Grenier
- Laboratory for Soft Tissue Research, Hospital for Special Surgery, New York, New York
| | - Niall A Smyth
- Laboratory for Soft Tissue Research, Hospital for Special Surgery, New York, New York
| | - Charles P Hannon
- Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, New York
| | - Keir A Ross
- Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, New York
| | - Peter A Torzilli
- Laboratory for Soft Tissue Research, Hospital for Special Surgery, New York, New York
| | - John G Kennedy
- Department of Foot and Ankle Surgery, Hospital for Special Surgery, New York, New York
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15
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Hafke B, Petri M, Suero E, Neunaber C, Kwisda S, Krettek C, Jagodzinski M, Omar M. Chondrocyte survival in osteochondral transplant cylinders depends on the harvesting technique. INTERNATIONAL ORTHOPAEDICS 2015; 40:1553-8. [PMID: 26660516 DOI: 10.1007/s00264-015-3065-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 11/27/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE In autologous osteochondral transplantation, the edges of the harvested plug are particularly susceptible to mechanical or thermal damage to the chondrocytes. We hypothesised that the applied harvesting device has an impact on chondrocyte vitality. METHODS Both knees of five blackhead sheep (ten knees) underwent open osteochondral plug harvesting with three different circular harvesting devices (osteoarticular transfer system harvester [OATS; diameter 8 mm; Arthrex, Munich, Germany], diamond cutter [DC; diameter 8.35 mm; Karl Storz, Tuttlingen, Germany] and hollow reamer with cutting crown [HRCC; diameter 7 mm; Dannoritzer, Tuttlingen, Germany]) from distinctly assigned anatomical sites of the knee joint. The rotary cutters (DC and HRCC) were either used with (+) or without cooling (-). Surgical cuts of the cartilage with a scalpel blade were chosen as control method. After cryotomy cutting, chondrocyte vitality was assessed using fluorescence microscopy and a Live/Dead assay. RESULTS There were distinct patterns of chondrocyte vitality, with reproducible accumulations of dead chondrocytes along the harvesting edge. No statistical difference in chondrocyte survivorship was seen between the OATS technique and the control method, or between the HRCC+ technique and the control method (P > 0.05). The DC+, HRCC- and DC- techniques yielded significantly lower chondrocyte survival rates compared with the control method (P < 0.05). CONCLUSIONS Chondrocyte survival in osteochondral cylinders depends on the applied harvesting technique. The use of rotary cutters without cooling yielded worst results, while the traditional OATS punch and rotary cutters with cooling achieved comparable rates of chondrocyte vitality.
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Affiliation(s)
- Benedikt Hafke
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Maximilian Petri
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Eduardo Suero
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Claudia Neunaber
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Sebastian Kwisda
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Christian Krettek
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Michael Jagodzinski
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - Mohamed Omar
- Trauma Department, Hannover Medical School, Carl-Neuberg-Straße 1, 30625, Hannover, Germany.
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16
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Houston DA, Amin AK, White TO, Smith IDM, Hall AC. Chondrocyte death after drilling and articular screw insertion in a bovine model. Osteoarthritis Cartilage 2013; 21:721-9. [PMID: 23428599 DOI: 10.1016/j.joca.2013.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 01/30/2013] [Accepted: 02/07/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Intra-articular screws are used for internal fixation of osteochondral fragments after fracture or osteochondritis dissecans. This causes cartilage injury potentially leading to chondrocyte death. We have visualised/quantified the hole and zone of cell death (ZCD) in cartilage after drilling/insertion of various articular screws. METHOD Using an ex vivo bovine model with transmitted light and confocal laser scanning microscopy (CLSM), the holes and ZCD following drilling/insertion of articular screws (cortical screw, headless variable pitch metallic screw, headless variable pitch bioabsorbable screw) were evaluated. In situ chondrocyte death was determined by live/dead cell viability assay. An imaging/quantification protocol was developed to compare hole diameter and ZCD from drilling/insertion of screws into cartilage. The effect of saline irrigation during drilling on the ZCD was also quantified. RESULTS Screw insertion created holes in cartilage that were significantly (P ≤ 0.001) less than the diameters of the equipment used. With a 1.5 mm drill, a ZCD of 580.2 ± 124 μm was produced which increased to 637.0 ± 44 μm following insertion of a 2 mm cortical screw although this was not significant (P > 0.05). The ZCD from insertion of the variable pitch headless screws (diam. 3.5 mm) was lower for the metallic compared to the bioabsorbable design (800.9 ± 159 vs 1,236.4 ± 212 μm, respectively; P < 0.01). The ZCD from drilling was reduced ∼50% (P < 0.001) by saline irrigation. CONCLUSIONS Cartilage injury during intra-articular screw fixation caused a ZCD around the hole irrespective of screw design. Saline irrigation significantly reduced the ZCD from drilling into cartilage.
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Affiliation(s)
- D A Houston
- Centre for Integrative Physiology, School of Biomedical Sciences, Hugh Robson Building, George Square, Edinburgh EH8 9XD, Scotland, UK
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Brenner JM, Kunz M, Tse MY, Winterborn A, Bardana DD, Pang SC, Waldman SD. Development of large engineered cartilage constructs from a small population of cells. Biotechnol Prog 2013. [DOI: 10.1002/btpr.1670] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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