Porous tantalum biocomposites for osteochondral defect repair: A follow-up study in a sheep model

Objectives

We sought to determine if a durable bilayer implant composed of trabecular metal with autologous periosteum on top would be suitable to reconstitute large osteochondral defects. This design would allow for secure implant fixation, subsequent integration and remodeling.

Materials and Methods

Adult sheep were randomly assigned to one of three groups (n = 8/group): 1. trabecular metal/periosteal graft (TMPG), 2. trabecular metal (TM), 3. empty defect (ED). Cartilage and bone healing were assessed macroscopically, biochemically (type II collagen, sulfated glycosaminoglycan (sGAG) and double-stranded DNA (dsDNA) content) and histologically.

Results

At 16 weeks post-operatively, histological scores amongst treatment groups were not statistically different (TMPG: overall 12.7, cartilage 8.6, bone 4.1; TM: overall 14.2, cartilage 9.5, bone 4.9; ED: overall 13.6, cartilage 9.1, bone 4.5). Metal scaffolds were incorporated into the surrounding bone, both in TM and TMPG. The sGAG yield was lower in the neo-cartilage regions compared with the articular cartilage (AC) controls (TMPG 20.8/AC 39.5, TM 25.6/AC 33.3, ED 32.2/AC 40.2 µg sGAG/1 mg respectively), with statistical significance being achieved for the TMPG group (p < 0.05). Hypercellularity of the neo-cartilage was found in TM and ED, as the dsDNA content was significantly higher (p < 0.05) compared with contralateral AC controls (TM 126.7/AC 71.1, ED 99.3/AC 62.8 ng dsDNA/1 mg). The highest type II collagen content was found in neo-cartilage after TM compared with TMPG and ED (TM 60%/TMPG 40%/ED 39%). Inter-treatment differences were not significant.

Conclusions

TM is a highly suitable material for the reconstitution of osseous defects. TM enables excellent bony ingrowth and fast integration. However, combined with autologous periosteum, such a biocomposite failed to promote satisfactory neo-cartilage formation.

Cite this article: E. H. Mrosek, H-W. Chung, J. S. Fitzsimmons, S. W. O’Driscoll, G. G. Reinholz, J. C. Schagemann. Porous tantalum biocomposites for osteochondral defect repair: A follow-up study in a sheep model. Bone Joint J 2016;5:403–411. DOI: 10.1302/2046-3758.59.BJR-2016-0070.R1.

Poly-epsilon-caprolactone/gel hybrid scaffolds for cartilage tissue engineering

The aim of this study was to determine the suitability of hybrid scaffolds composed of naturally derived biopolymer gels and macroporous poly-epsilon-caprolactone (PCL) scaffolds for neocartilage formation in vitro. Rabbit articular chondrocytes were seeded into PCL/HA (1 wt % hyaluronan), PCL/CS (0.5 wt % chitosan), PCL/F (1:3 fibrin sealant plus aprotinin), and PCL/COL1 (0.24% type I collagen) hybrids and cultured statically for up to 50 days. Growth characteristics were evaluated by histological analysis, scanning electron microscopy, and confocal laser scanning microscopy. Neocartilage was quantified using a dimethyl-methylene blue assay for sulfated glycosaminoglycans (sGAG) and an enzyme-linked immunosorbent assay for type II collagen (COL2), normalized to dsDNA content by fluorescent PicoGreen assay. Chondrocytes were homogenously distributed throughout the entire scaffold and exhibited a predominantly spheroidal shape 1 h after being seeded into scaffolds. Immunofluorescence depicted expanding proteoglycan deposition with time. The sGAG per dsDNA increased in all hybrids between days 25 and 50. PCL/HA scaffolds consistently promoted highest yields. In contrast, total sGAG and total COL2 decreased in all hybrids except PCL/CS, which favored increasing values and a significantly higher total COL2 at day 50. Overall, dsDNA content decreased significantly with time, and particularly between days 3 and 6. The PCL/HA hybrid displayed two proliferation peaks at days 3 and 25, and PCL/COL1 displayed one proliferation peak at day 12. The developed hybrids provided distinct short-term environments for implanted chondrocytes, with not all of them being explicitly beneficial (PCL/F, PCL/COL1). The PCL/HA and PCL/CS hybrids, however, promoted specific neocartilage formation and initial cell retention and are thus promising for cartilage tissue engineering.

Subchondral bone trauma causes cartilage matrix degeneration: an immunohistochemical analysis in a canine model

Joint instability was believed to be the main cause of osteoarthritis following non-fracture articular trauma. However, sudden high impact load through articular cartilage onto subchondral bone may also cause osteoarthritic changes.

OBJECTIVE

We asked whether early osteoarthritic changes following transarticular impact may be depicted using immunofluorescence on unfixed cryosections to contribute to a more detailed understanding of degenerative processes of joint impaction.

DESIGN

Transarticular impacts were applied to patellofemoral joints of 12 skeletally mature beagle dogs (age: 15-16 months) using a drop tower. Biopsies of impact areas were sampled after 6 months and processed for standard light microscopy on formalin-fixed sections and for immunofluorescence for collagen type I (col I), type II (col II) and aggrecan (AC) on unfixed cryosections. Gross morphology and immunofluorescence on cryosections were documented using a semi-quantitative scaling system, compared to healthy controls and to standard light microscopy.

RESULTS

Four biopsies showed almost entirely fibrocartilaginous morphology, four appeared to be of preserved hyaline morphology with only minor signs of fibrocartilaginous remodelling and four showed preserved hyaline appearance. We found decrease in col II and AC expression in highly degenerative specimens as well as increase of col I expression. Increased col I expression in the pericellular matrix could even be depicted in specimens with intact hyaline morphology.

DISCUSSION/CONCLUSION

Observations suggest that joint impaction causes early osteoarthritic changes after 6 months. Collagen network disruption seems to lead to AC loss, although other researchers found isolated AC loss without denaturation of col II using immunofluorescence in formalin-fixed specimens. This is the first study on effects of transarticular impact using immunofluorescence on unfixed cryosections.