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Capurro B, Tey-Pons M, Carrera A, Marqués-López F, Marín-Peña O, Torres-Eguía R, Monllau JC, Reina F. Polyurethane Scaffold vs Fascia Lata Autograft for Hip Labral Reconstruction: Comparison of Femoroacetabular Biomechanics. Orthop J Sports Med 2023; 11:23259671221150632. [PMID: 36846818 PMCID: PMC9944198 DOI: 10.1177/23259671221150632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
Background The integrity of the acetabular labrum is critical in providing normal function and minimizing hip degeneration and is considered key for success in today's hip preservation algorithm. Many advances have been made in labral repair and reconstruction to restore the suction seal. Purpose/Hypothesis To compare the biomechanical effects of segmental labral reconstruction between the synthetic polyurethane scaffold (PS) and fascia lata autograft (FLA). Our hypothesis was that reconstruction with a macroporous polyurethane implant and autograft reconstruction of fascia lata would normalize hip joint kinetics and restore the suction seal. Study Design Controlled laboratory study. Methods Ten cadaveric hips from 5 fresh-frozen pelvises underwent biomechanical testing with a dynamic intra-articular pressure measurement system under 3 conditions: (1) intact labrum, (2) reconstruction with PS after a 3-cm segmental labrectomy, then (3) reconstruction with FLA. Contact area, contact pressure, and peak force were evaluated in 4 positions: 90º of flexion in neutral, 90º of flexion plus internal rotation, 90º of flexion plus external rotation, and 20º of extension. A labral seal test was performed for both reconstruction techniques. The relative change from the intact condition (value = 1) was determined for all conditions and positions. Results PS restored contact area to at least 96% of intact (≥0.96; range, 0.96-0.98) in all 4 positions, and FLA restored contact area to at least 97% (≥0.97; range, 0.97-1.19). Contact pressure was restored to ≥1.08 (range, 1.08-1.11) with the PS and ≥1.08 (range, 1.08-1.10) with the FLA technique. Peak force returned to ≥1.02 (range, 1.02-1.05) with PS and ≥1.02 (range, 1.02-1.07) with FLA. No significant differences were found between the reconstruction techniques in contact area in any position (P > .06), with the exception that FLA presented greater contact area in flexion plus internal rotation as compared with PS (P = .003). Suction seal was confirmed in 80% of PSs and 70% of FLAs (P = .62). Conclusion Segmental hip labral reconstruction using PS and FLA reapproximated femoroacetabular contact biomechanics close to the intact state. Clinical Relevance These findings provide preclinical evidence supporting the use of a synthetic scaffold as an alternative to FLA and therefore avoiding donor site morbidity.
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Affiliation(s)
- Bruno Capurro
- Department of Orthopaedic Surgery and Traumatology, Hospital del
Mar, Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Orthopaedic Surgery and Sport Traumatology, ReSport
Clinic, Barcelona, Spain.,Clinical Anatomy, Embryology and Neuroscience Research Group,
Medical Sciences Department, Faculty of Medicine, University of Girona, Girona,
Spain.,Grupo Ibérico de Cirugía de Preservación de Cadera, Portugal and
Spain.,Bruno Capurro Soler, PhD, Department of Orthopaedic Surgery and
Traumatology, Hospital del Mar, Passeig Marítim de la Barceloneta, 25, 08003,
Barcelona, Spain () (Twitter:
@DrBrunoCapurro)
| | - Marc Tey-Pons
- Department of Orthopaedic Surgery and Traumatology, Hospital del
Mar, Universitat Autònoma de Barcelona, Barcelona, Spain.,Grupo Ibérico de Cirugía de Preservación de Cadera, Portugal and
Spain
| | - Anna Carrera
- Clinical Anatomy, Embryology and Neuroscience Research Group,
Medical Sciences Department, Faculty of Medicine, University of Girona, Girona,
Spain
| | - Fernando Marqués-López
- Department of Orthopaedic Surgery and Traumatology, Hospital del
Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Oliver Marín-Peña
- Grupo Ibérico de Cirugía de Preservación de Cadera, Portugal and
Spain.,Department of Orthopaedic Surgery and Traumatology, Hospital Infanta
Leonor, Madrid, Spain
| | - Raúl Torres-Eguía
- Grupo Ibérico de Cirugía de Preservación de Cadera, Portugal and
Spain.,Department of Orthopaedic Surgery and Traumatology, Clínica Cemtro,
Madrid, Spain
| | - Joan Carles Monllau
- Department of Orthopaedic Surgery and Traumatology, Hospital del
Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Francisco Reina
- Clinical Anatomy, Embryology and Neuroscience Research Group,
Medical Sciences Department, Faculty of Medicine, University of Girona, Girona,
Spain
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Capurro B, Reina F, Carrera A, Monllau JC, Marqués-López F, Marín-Peña O, Torres-Eguía R, Tey-Pons M. Hip Labral Reconstruction With a Polyurethane Scaffold: Restoration of Femoroacetabular Contact Biomechanics. Orthop J Sports Med 2022; 10:23259671221118831. [PMID: 36119123 PMCID: PMC9478710 DOI: 10.1177/23259671221118831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 05/26/2022] [Indexed: 11/18/2022] Open
Abstract
Background: Many advances have been made in hip labral repair and reconstruction and in
the restoration of the suction seal. Purpose/Hypothesis: The purpose of this study was to evaluate the biomechanical effects of
segmental labral reconstruction with a synthetic polyurethane scaffold (PS)
in comparison with segmental labrectomy. Our hypothesis was that
reconstruction with a icroporous polyurethane implant would normalize joint
kinetics of the hip and restore the suction seal. Study Design: Controlled laboratory study. Methods: We used 10 hips from 5 fresh-frozen pelvises with an intact acetabular labrum
without osteoarthritis. Using an intra-articular pressure measurement
system, the contact area, contact pressure, and peak force were assessed for
the following conditions: intact labrum, partial anterosuperior labrectomy,
and PS reconstruction. For each condition, all specimens were analyzed in 4
positions (90° of flexion, 90° of flexion and internal rotation, 90° of
flexion and external rotation, and 20° of extension) and underwent a labral
seal test. The relative change from the intact condition was determined for
all conditions and positions. Results: Compared with the intact labrum, labrectomy resulted in a significant
decrease in the contact area (P < .001) and a
significant increase in the peak force (P < .001) and
contact pressure (P < .001) across all positions.
Compared with labrectomy, PS reconstruction resulted in a significant
increase in the contact area (P < .001) and a
significant decrease in the contact pressure (P ≤ .02) and
peak force (P < .001) across all positions. Compared
with the intact labrum, PS reconstruction restored the contact area and peak
force to normal values in all positions (P > .05),
whereas the contact pressure was significantly decreased compared with
labrectomy (P < .05) but did not return to normal
values. The labral seal was lost in all specimens after labrectomy but was
restored in 80% of the specimens after PS reconstruction. Conclusion: Femoroacetabular contact biomechanics significantly worsened after partial
labrectomy; reconstruction using a PS restored the contact area and peak
force to the intact state and improved the contact pressure increases seen
after partial labrectomy. The contact area and peak force were normalized,
and the labral seal was re-established in most cases. Clinical Relevance: This study provides biomechanical evidence for the use of a scaffold for
labral reconstruction.
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Affiliation(s)
- Bruno Capurro
- Department of Orthopaedic Surgery and Traumatology, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Orthopaedic Surgery and Sport Traumatology, ReSport Clinic, Barcelona, Spain.,NEOMA Research Group, Department of Medical Sciences, Universitat de Girona, Girona, Spain.,GIPCA - Grupo Ibérico de cirugía Preservación de Cadera, Spain - Portugal
| | - Francisco Reina
- NEOMA Research Group, Department of Medical Sciences, Universitat de Girona, Girona, Spain
| | - Anna Carrera
- NEOMA Research Group, Department of Medical Sciences, Universitat de Girona, Girona, Spain
| | - Joan Carles Monllau
- Department of Orthopaedic Surgery and Traumatology, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Fernando Marqués-López
- Department of Orthopaedic Surgery and Traumatology, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Oliver Marín-Peña
- GIPCA - Grupo Ibérico de cirugía Preservación de Cadera, Spain - Portugal.,Department of Orthopaedic Surgery and Traumatology, Hospital Infanta Leonor, Universidad Complutense de Madrid, Madrid, Spain
| | - Raúl Torres-Eguía
- GIPCA - Grupo Ibérico de cirugía Preservación de Cadera, Spain - Portugal.,Department of Orthopaedic Surgery and Traumatology, Clínica CEMTRO, Madrid, Spain
| | - Marc Tey-Pons
- Department of Orthopaedic Surgery and Traumatology, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain.,GIPCA - Grupo Ibérico de cirugía Preservación de Cadera, Spain - Portugal
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3
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Olivos-Meza A, Pérez Jiménez FJ, Granados-Montiel J, Landa-Solís C, Cortés González S, Jiménez Aroche CA, Valdez Chávez M, Renán León S, Gomez-Garcia R, Martínez-López V, Ortega-Sánchez C, Parra-Cid C, Velasquillo Martinez C, Ibarra C. First Clinical Application of Polyurethane Meniscal Scaffolds with Mesenchymal Stem Cells and Assessment of Cartilage Quality with T2 Mapping at 12 Months. Cartilage 2021; 13:197S-207S. [PMID: 31387368 PMCID: PMC8808880 DOI: 10.1177/1947603519852415] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Complex meniscal lesions often require meniscectomy with favorable results in the short term but a high risk of early osteoarthritis subsequently. Partial meniscectomy treated with meniscal substitutes may delay articular cartilage degeneration. PURPOSE To evaluate the status of articular cartilage by T2 mapping after meniscal substitution with polyurethane scaffolds enriched with mesenchymal stem cells (MSC) and comparison with acellular scaffolds at 12 months. METHODS Seventeen patients (18-50 years) with past meniscectomies were enrolled in 2 groups: (1) acellular polyurethane scaffold (APS) or (2) polyurethane scaffold enriched with MSC (MPS). Patients in the MPS group received filgrastim to stimulate MSC production, and CD90+ cells were obtained and cultured in the polyurethane scaffold. The scaffolds were implanted arthroscopically into partial meniscus defects. Concomitant injuries (articular cartilage lesions or cartilage lesions) were treated during the same procedure. Changes in the quality of articular cartilage were evaluated with T2 mapping in femur and tibia at 12 months. RESULTS In tibial T2 mapping, values for the MPS group increased slightly at 9 months but returned to initial values at 12 months (P > 0.05). In the APS group, a clear decrease from 3 months to 12 months was observed (P > 0.05). This difference tended to be significantly lower in the APS group compared with the MPS group at the final time point (P = 0.18). In the femur, a slight increase in the MPS group (47.8 ± 3.4) compared with the APS group (45.3 ± 4.9) was observed (P > 0.05). CONCLUSION Meniscal substitution with polyurethane scaffold maintains normal T2 mapping values in adjacent cartilage at 12 months. The addition of MSC did not show any advantage in the protection of articular cartilage over acellular scaffolds (P > 0.05).
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Affiliation(s)
- Anell Olivos-Meza
- Instituto Nacional de Rehabilitacion
“Luis Guillermo Ibarra Ibarra”, Mexico City, Mexico
| | | | - Julio Granados-Montiel
- Instituto Nacional de Rehabilitacion
“Luis Guillermo Ibarra Ibarra”, Mexico City, Mexico
| | - Carlos Landa-Solís
- Instituto Nacional de Rehabilitacion
“Luis Guillermo Ibarra Ibarra”, Mexico City, Mexico
| | | | | | - Marco Valdez Chávez
- Instituto Nacional de Rehabilitacion
“Luis Guillermo Ibarra Ibarra”, Mexico City, Mexico
| | - Saúl Renán León
- Instituto Nacional de Rehabilitacion
“Luis Guillermo Ibarra Ibarra”, Mexico City, Mexico
| | - Ricardo Gomez-Garcia
- Instituto Nacional de Rehabilitacion
“Luis Guillermo Ibarra Ibarra”, Mexico City, Mexico
| | | | - Carmina Ortega-Sánchez
- Instituto Nacional de Rehabilitacion
“Luis Guillermo Ibarra Ibarra”, Mexico City, Mexico
| | - Carmen Parra-Cid
- Instituto Nacional de Rehabilitacion
“Luis Guillermo Ibarra Ibarra”, Mexico City, Mexico
| | | | - Clemente Ibarra
- Instituto Nacional de Rehabilitacion
“Luis Guillermo Ibarra Ibarra”, Mexico City, Mexico,Clemente Ibarra, Instituto Nacional de
Rehabilitación “Luis Guillermo Ibarra Ibarra”, Calzada Mexico-Xochimilco No.
289, Col. Arenal de Guadalupe, Tlalpan, 14389; Mexico City, Mexico.
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4
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Tschon M, Brogini S, Parrilli A, Bertoldi S, Silini A, Parolini O, Faré S, Martini L, Veronesi F, Fini M, Giavaresi G. Assessment of the in vivo biofunctionality of a biomimetic hybrid scaffold for osteochondral tissue regeneration. Biotechnol Bioeng 2020; 118:465-480. [PMID: 32997340 DOI: 10.1002/bit.27584] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 09/25/2020] [Accepted: 09/28/2020] [Indexed: 02/06/2023]
Abstract
Chondral and osteochondral lesions represent one of the most challenging problems in the orthopedic field, as these types of injuries lead to disability and worsened quality of life for patients and have an economic impact on the healthcare system. The aim of this in vivo study was to develop a new tissue engineering approach through a hybrid scaffold for osteochondral tissue regeneration made of porous polyurethane foam (PU) coated under vacuum with calcium phosphates (PU/VAC). Scaffold characterization showed a highly porous and interconnected structure. Human amniotic mesenchymal stromal cells (hAMSCs) were loaded into scaffolds using pectin (PECT) as a carrier. Osteochondral defects in medial femoral condyles of rabbits were created and randomly allocated in one of the following groups: plain scaffold (PU/VAC), scaffold with hAMSCs injected in the implant site (PU/VAC/hAMSC), scaffold with hAMSCs loaded in pectin (PU/VAC/PECT/hAMSC), and no treated defects (untreated). The therapeutic efficacy was assessed by macroscopic, histological, histomorphometric, microtomographic, and ultrastructural analyses at 3, 6, 12, and 24 weeks. Histological results showed that the scaffold was permissive to tissue growth and penetration, an immature osteocartilaginous tissue was observed at early experimental times, with a more accentuated bone regeneration in comparison with the cartilage layer in the absence of any inflammatory reaction.
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Affiliation(s)
- Matilde Tschon
- IRCCS-Istituto Ortopedico Rizzoli, Complex Structure of Surgical Sciences and Technologies, Bologna, Italy
| | - Silvia Brogini
- IRCCS-Istituto Ortopedico Rizzoli, Complex Structure of Surgical Sciences and Technologies, Bologna, Italy
| | - Annapaola Parrilli
- Empa, Swiss Federal Laboratories for Materials Science and Technology, Dübendorf, Switzerland
| | - Serena Bertoldi
- Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, Milan, Italy.,INSTM, National Interuniversity Consortium of Materials Science and Technology, Florence, Italy
| | - Antonietta Silini
- Centro di Ricerca E. Menni, Fondazione Poliambulanza Istituto Ospedaliero, via Bissolati 57, Brescia, Italy
| | - Ornella Parolini
- Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italy.,Dipartimento di Scienze della Vita e Sanità Pubblica, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Silvia Faré
- Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, Milan, Italy.,INSTM, National Interuniversity Consortium of Materials Science and Technology, Florence, Italy
| | - Lucia Martini
- IRCCS-Istituto Ortopedico Rizzoli, Complex Structure of Surgical Sciences and Technologies, Bologna, Italy
| | - Francesca Veronesi
- IRCCS-Istituto Ortopedico Rizzoli, Complex Structure of Surgical Sciences and Technologies, Bologna, Italy
| | - Milena Fini
- IRCCS-Istituto Ortopedico Rizzoli, Complex Structure of Surgical Sciences and Technologies, Bologna, Italy
| | - Gianluca Giavaresi
- IRCCS-Istituto Ortopedico Rizzoli, Complex Structure of Surgical Sciences and Technologies, Bologna, Italy
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5
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Gupta P, Pérez-Mancera PA, Kocher H, Nisbet A, Schettino G, Velliou EG. A Novel Scaffold-Based Hybrid Multicellular Model for Pancreatic Ductal Adenocarcinoma-Toward a Better Mimicry of the in vivo Tumor Microenvironment. Front Bioeng Biotechnol 2020; 8:290. [PMID: 32391339 PMCID: PMC7193232 DOI: 10.3389/fbioe.2020.00290] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 03/19/2020] [Indexed: 12/11/2022] Open
Abstract
With a very low survival rate, pancreatic ductal adenocarcinoma (PDAC) is a deadly disease. This has been primarily attributed to (i) its late diagnosis and (ii) its high resistance to current treatment methods. The latter specifically requires the development of robust, realistic in vitro models of PDAC, capable of accurately mimicking the in vivo tumor niche. Advancements in the field of tissue engineering (TE) have helped the development of such models for PDAC. Herein, we report for the first time a novel hybrid, polyurethane (PU) scaffold-based, long-term, multicellular (tri-culture) model of pancreatic cancer involving cancer cells, endothelial cells, and stellate cells. Recognizing the importance of ECM proteins for optimal growth of different cell types, the model consists of two different zones/compartments: an inner tumor compartment consisting of cancer cells [fibronectin (FN)-coated] and a surrounding stromal compartment consisting of stellate and endothelial cells [collagen I (COL)-coated]. Our developed novel hybrid, tri-culture model supports the proliferation of all different cell types for 35 days (5 weeks), which is the longest reported timeframe in vitro. Furthermore, the hybrid model showed extensive COL production by the cells, mimicking desmoplasia, one of PDAC's hallmark features. Fibril alignment of the stellate cells was observed, which attested to their activated state. All three cell types expressed various cell-specific markers within the scaffolds, throughout the culture period and showed cellular migration between the two zones of the hybrid scaffold. Our novel model has great potential as a low-cost tool for in vitro studies of PDAC, as well as for treatment screening.
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Affiliation(s)
- Priyanka Gupta
- Bioprocess and Biochemical Engineering Group (BioProChem), Department of Chemical and Process Engineering, University of Surrey, Guildford, United Kingdom
| | - Pedro A. Pérez-Mancera
- Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Hemant Kocher
- Centre for Tumour Biology and Experimental Cancer Medicine, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Andrew Nisbet
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Giuseppe Schettino
- Department of Physics, University of Surrey, Guildford, United Kingdom
- Medical Radiation Science Group, The National Physical Laboratory, Teddington, United Kingdom
| | - Eirini G. Velliou
- Bioprocess and Biochemical Engineering Group (BioProChem), Department of Chemical and Process Engineering, University of Surrey, Guildford, United Kingdom
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6
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Iga C, Paweł S, Marcin Ł, Justyna KL. Polyurethane Composite Scaffolds Modified with the Mixture of Gelatin and Hydroxyapatite Characterized by Improved Calcium Deposition. Polymers (Basel) 2020; 12:polym12020410. [PMID: 32054055 PMCID: PMC7077717 DOI: 10.3390/polym12020410] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/01/2020] [Accepted: 02/04/2020] [Indexed: 01/08/2023] Open
Abstract
The skeleton is a crucial element of the motion system in the human body, whose main function is to support and protect the soft tissues. Furthermore, the elements of the skeleton act as a storage place for minerals and participate in the production of red blood cells. The bone tissue includes the craniomaxillofacial bones, ribs, and spine. There are abundant reports in the literature indicating that the amount of treatments related to bone fractures increases year by year. Nowadays, the regeneration of the bone tissue is performed by using autografts or allografts, but this treatment method possesses a few disadvantages. Therefore, new and promising methods of bone tissue regeneration are constantly being sought. They often include the implantation of tissue scaffolds, which exhibit proper mechanical and osteoconductive properties. In this paper, the preparation of polyurethane (PUR) scaffolds modified by gelatin as the reinforcing factor and hydroxyapatite as the bioactive agent was described. The unmodified and modified scaffolds were tested for their mechanical properties; morphological assessments using optical microscopy were also conducted, as was the ability for calcification using scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX). Moreover, each type of scaffold was subjected to a degradation process in 5M NaOH and 2M HCl aqueous solutions. It was noticed that the best properties promoting the calcium phosphate deposition were obtained for scaffolds modified with 2% gelatin solution containing 5% of hydroxyapatite.
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Affiliation(s)
- Carayon Iga
- Department of Polymers Technology, Faculty of Chemistry, Gdansk University of Technology (GUT), Narutowicza Street 11/12, 80233 Gdansk, Poland; (C.I.); (S.P.)
| | - Szarlej Paweł
- Department of Polymers Technology, Faculty of Chemistry, Gdansk University of Technology (GUT), Narutowicza Street 11/12, 80233 Gdansk, Poland; (C.I.); (S.P.)
| | - Łapiński Marcin
- Department of Solid State Physics, Faculty of Applied Physics and Mathematics, Gdansk University of Technology (GUT), Narutowicza Street 11/12, 80233 Gdansk, Poland;
| | - Kucińska-Lipka Justyna
- Department of Polymers Technology, Faculty of Chemistry, Gdansk University of Technology (GUT), Narutowicza Street 11/12, 80233 Gdansk, Poland; (C.I.); (S.P.)
- Correspondence:
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7
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Du J, Long R, Nakai T, Sakai D, Benneker L, Zhou G, Li B, Eglin D, Iatridis J, Alini M, Grad S, Li Z. Functional cell phenotype induction with TGF-β1 and collagen- polyurethane scaffold for annulus fibrosus rupture repair. Eur Cell Mater 2020; 39:1-17. [PMID: 31899537 PMCID: PMC7027376 DOI: 10.22203/ecm.v039a01] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Appropriate cell sources, bioactive factors and biomaterials for generation of functional and integrated annulus fibrosus (AF) tissue analogues are still an unmet need. In the present study, the AF cell markers, collagen type I, cluster of differentiation 146 (CD146), mohawk (MKX) and smooth muscle protein 22α (SM22α) were found to be suitable indicators of functional AF cell induction. In vitro 2D culture of human AF cells showed that transforming growth factor β1 (TGF-β1) upregulated the expression of the functional AF markers and increased cell contractility, indicating that TGF-β1-pre-treated AF cells were an appropriate cell source for AF tissue regeneration. Furthermore, a tissue engineered construct, composed of polyurethane (PU) scaffold with a TGF-β1-supplemented collagen type I hydrogel and human AF cells, was evaluated with in vitro 3D culture and ex vivo preclinical bioreactor-loaded organ culture models. The collagen type I hydrogel helped maintaining the AF functional phenotype. TGF-β1 supplement within the collagen I hydrogel further promoted cell proliferation and matrix production of AF cells within in vitro 3D culture. In the ex vivo IVD organ culture model with physiologically relevant mechanical loading, TGF-β1 supplement in the transplanted constructs induced the functional AF cell phenotype and enhanced collagen matrix synthesis. In conclusion, TGF-β1-containing collagen-PU constructs can induce the functional cell phenotype of human AF cells in vitro and in situ. This combined cellular, biomaterial and bioactive agent therapy has a great potential for AF tissue regeneration and rupture repair.
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Affiliation(s)
- J. Du
- AO Research Institute Davos, Davos, Switzerland
| | - R.G. Long
- AO Research Institute Davos, Davos, Switzerland,Icahn School of Medicine at Mount Sinai, New York, USA,Collaborative Research Program Annulus Fibrosus Repair, AO Foundation, Davos, Switzerland
| | - T. Nakai
- Tokai University School of Medicine, Isehara, Japan,Collaborative Research Program Annulus Fibrosus Repair, AO Foundation, Davos, Switzerland
| | - D. Sakai
- Tokai University School of Medicine, Isehara, Japan,Collaborative Research Program Annulus Fibrosus Repair, AO Foundation, Davos, Switzerland
| | - L.M. Benneker
- Inselspital, University of Bern, Bern, Switzerland,Collaborative Research Program Annulus Fibrosus Repair, AO Foundation, Davos, Switzerland
| | - G. Zhou
- Shenzhen Key Laboratory of Anti-Aging and Regenerative Medicine, Department of Medical Cell Biology and Genetics, Health Sciences Centre, Shenzhen University, Shenzhen, China
| | - B. Li
- Orthopaedic Institute, Medical College, Soochow University, Suzhou, Jiangsu, China
| | - D. Eglin
- AO Research Institute Davos, Davos, Switzerland,Collaborative Research Program Annulus Fibrosus Repair, AO Foundation, Davos, Switzerland
| | - J.C. Iatridis
- Icahn School of Medicine at Mount Sinai, New York, USA,Collaborative Research Program Annulus Fibrosus Repair, AO Foundation, Davos, Switzerland
| | - M. Alini
- AO Research Institute Davos, Davos, Switzerland,Collaborative Research Program Annulus Fibrosus Repair, AO Foundation, Davos, Switzerland
| | - S. Grad
- AO Research Institute Davos, Davos, Switzerland,Collaborative Research Program Annulus Fibrosus Repair, AO Foundation, Davos, Switzerland
| | - Z. Li
- AO Research Institute Davos, Davos, Switzerland,Collaborative Research Program Annulus Fibrosus Repair, AO Foundation, Davos, Switzerland,Address for correspondence: Zhen Li, PhD, AO Research Institute Davos, Clavadelerstrasse 8, 7270, Davos Platz, Switzerland. Telephone number: +41 814142325
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8
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Lutzweiler G, Barthes J, Koenig G, Kerdjoudj H, Mayingi J, Boulmedais F, Schaaf P, Drenckhan W, Vrana NE. Modulation of Cellular Colonization of Porous Polyurethane Scaffolds via the Control of Pore Interconnection Size and Nanoscale Surface Modifications. ACS Appl Mater Interfaces 2019; 11:19819-19829. [PMID: 31074959 DOI: 10.1021/acsami.9b04625] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Full-scale cell penetration within porous scaffolds is required to obtain functional connective tissue components in tissue engineering applications. For this aim, we produced porous polyurethane structures with well-controlled pore and interconnection sizes. Although the influence of the pore size on cellular behavior is widely studied, we focused on the impact of the size of the interconnections on the colonization by NIH 3T3 fibroblasts and Wharton's jelly-derived mesenchymal stem cells (WJMSCs). To render the material hydrophilic and allow good material wettability, we treated the material either by plasma or by polydopamine (PDA) coating. We show that cells weakly adhere on these surfaces. Keeping the average pore diameter constant at 133 μm, we compare two structures, one with LARGE (52 μm) and one with SMALL (27 μm) interconnection diameters. DNA quantification and extracellular matrix (ECM) production reveal that larger interconnections is more suitable for cells to move across the scaffold and form a three-dimensional cellular network. We argue that LARGE interconnections favor cell communication between different pores, which then favors the production of the ECM. Moreover, PDA treatment shows a truly beneficial effect on fibroblast viability and on matrix production, whereas plasma treatment shows the same effect for WJMSCs. We, therefore, claim that both pore interconnection size and surface treatment play a significant role to improve the quality of integration of tissue engineering scaffolds.
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Affiliation(s)
- G Lutzweiler
- Institut National de la Santé et de la Recherche Medicale, UMR_S 1121 , 11 rue Humann , 67085 Strasbourg Cedex , France
- Faculté de Chirurgie Dentaire , Université de Strasbourg , 8 rue Sainte Elisabeth , 67000 Strasbourg , France
- Université de Strasbourg, CNRS, Institut Charles Sadron , 23 rue de Loess , 67034 Strasbourg , France
| | - J Barthes
- Protip Medical SAS , 8 Place de l'Hôpital , 67000 Strasbourg , France
| | - G Koenig
- Institut National de la Santé et de la Recherche Medicale, UMR_S 1121 , 11 rue Humann , 67085 Strasbourg Cedex , France
- Faculté de Chirurgie Dentaire , Université de Strasbourg , 8 rue Sainte Elisabeth , 67000 Strasbourg , France
| | - H Kerdjoudj
- EA 4691, Biomateŕiaux et Inflammation en Site Osseux (BIOS), SFR-CAP Santé (FED4231), Université de Reims Champagne Ardenne , 51100 Reims , France
- UFR d'Odontologie, Université de Reims Champagne Ardenne , 51100 Reims , France
| | - J Mayingi
- Cetim Grand Est , 24a Rue d'Alsace , 67400 Illkirch-Graffenstaden , France
| | - F Boulmedais
- Université de Strasbourg, CNRS, Institut Charles Sadron , 23 rue de Loess , 67034 Strasbourg , France
| | - P Schaaf
- Institut National de la Santé et de la Recherche Medicale, UMR_S 1121 , 11 rue Humann , 67085 Strasbourg Cedex , France
- Faculté de Chirurgie Dentaire , Université de Strasbourg , 8 rue Sainte Elisabeth , 67000 Strasbourg , France
| | - W Drenckhan
- Université de Strasbourg, CNRS, Institut Charles Sadron , 23 rue de Loess , 67034 Strasbourg , France
| | - N E Vrana
- Protip Medical SAS , 8 Place de l'Hôpital , 67000 Strasbourg , France
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9
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Vedicherla S, Romanazzo S, Kelly DJ, Buckley CT, Moran CJ. Chondrocyte-based intraoperative processing strategies for the biological augmentation of a polyurethane meniscus replacement. Connect Tissue Res 2018; 59:381-392. [PMID: 29182439 DOI: 10.1080/03008207.2017.1402892] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
UNLABELLED Purpose/aim of study: Menisectomies account for over 1.5 million surgical interventions in Europe annually, and there is a growing interest in regenerative strategies to improve outcomes in meniscal replacement. The overall objective of this study was to evaluate the role of intraoperatively applied fresh chondrocyte (FC) isolates compared to minced cartilage (MC) fragments, used without cell isolation, to improve bioactivity and tissue integration when combined with a polyurethane replacement. MATERIALS AND METHODS First, to optimize the intraoperative cell isolation protocol, caprine articular cartilage biopsies were digested with 750 U/ml or 3000 U/ml collagenase type II (ratio of 10 ml per g of tissue) for 30 min, 1 h or 12 h with constant agitation and compared to culture-expanded chondrocytes in terms of matrix deposition when cultured on polyurethane scaffolds. Finally, FCs and MC-augmented polyurethane scaffolds were evaluated in a caprine meniscal explant model to assess the potential enhancements on tissue integration strength. RESULTS Adequate numbers of FCs were harvested using a 30 min chondrocyte isolation protocol and were found to demonstrate improved matrix deposition compared to standard culture-expanded cells in vitro. Upon evaluation in a meniscus explant defect model, both FCs and MC showed improved matrix deposition at the tissue-scaffold interface and enhanced push-out strength, fourfold and 2.5-fold, respectively, compared with the acellular implant. CONCLUSIONS Herein, we have demonstrated a novel approach that could be applied intraoperatively, using FCs or MC for improved tissue integration with a polyurethane meniscal replacement.
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Affiliation(s)
- Srujana Vedicherla
- a Orthopaedics and Sports Medicine , School of Medicine, Trinity College , Dublin , Ireland.,c Trinity Centre for Bioengineering , Trinity Biomedical Sciences Institute, Trinity College , Dublin , Ireland
| | - Sara Romanazzo
- a Orthopaedics and Sports Medicine , School of Medicine, Trinity College , Dublin , Ireland.,c Trinity Centre for Bioengineering , Trinity Biomedical Sciences Institute, Trinity College , Dublin , Ireland
| | - Daniel J Kelly
- b Department of Mechanical & Manufacturing Engineering , School of Engineering, Trinity College , Dublin , Ireland.,c Trinity Centre for Bioengineering , Trinity Biomedical Sciences Institute, Trinity College , Dublin , Ireland.,d Advanced Materials and Bioengineering Research (AMBER) Centre , Royal College of Surgeons in Ireland & Trinity College , Dublin , Ireland
| | - Conor T Buckley
- b Department of Mechanical & Manufacturing Engineering , School of Engineering, Trinity College , Dublin , Ireland.,c Trinity Centre for Bioengineering , Trinity Biomedical Sciences Institute, Trinity College , Dublin , Ireland.,d Advanced Materials and Bioengineering Research (AMBER) Centre , Royal College of Surgeons in Ireland & Trinity College , Dublin , Ireland
| | - Cathal J Moran
- a Orthopaedics and Sports Medicine , School of Medicine, Trinity College , Dublin , Ireland.,c Trinity Centre for Bioengineering , Trinity Biomedical Sciences Institute, Trinity College , Dublin , Ireland.,d Advanced Materials and Bioengineering Research (AMBER) Centre , Royal College of Surgeons in Ireland & Trinity College , Dublin , Ireland.,e Sports Surgery Clinic , Santry , Dublin , Ireland
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10
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Achatz FP, Kujat R, Pfeifer CG, Koch M, Nerlich M, Angele P, Zellner J. In Vitro Testing of Scaffolds for Mesenchymal Stem Cell-Based Meniscus Tissue Engineering-Introducing a New Biocompatibility Scoring System. Materials (Basel) 2016; 9:E276. [PMID: 28773399 DOI: 10.3390/ma9040276] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 03/14/2016] [Accepted: 03/29/2016] [Indexed: 12/22/2022]
Abstract
A combination of mesenchymal stem cells (MSCs) and scaffolds seems to be a promising approach for meniscus repair. To facilitate the search for an appropriate scaffold material a reliable and objective in vitro testing system is essential. This paper introduces a new scoring for this purpose and analyzes a hyaluronic acid (HA) gelatin composite scaffold and a polyurethane scaffold in combination with MSCs for tissue engineering of meniscus. The pore quality and interconnectivity of pores of a HA gelatin composite scaffold and a polyurethane scaffold were analyzed by surface photography and Berliner-Blau-BSA-solution vacuum filling. Further the two scaffold materials were vacuum-filled with human MSCs and analyzed by histology and immunohistochemistry after 21 days in chondrogenic media to determine cell distribution and cell survival as well as proteoglycan production, collagen type I and II content. The polyurethane scaffold showed better results than the hyaluronic acid gelatin composite scaffold, with signs of central necrosis in the HA gelatin composite scaffolds. The polyurethane scaffold showed good porosity, excellent pore interconnectivity, good cell distribution and cell survival, as well as an extensive content of proteoglycans and collagen type II. The polyurethane scaffold seems to be a promising biomaterial for a mesenchymal stem cell-based tissue engineering approach for meniscal repair. The new score could be applied as a new standard for in vitro scaffold testing.
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11
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Teng S, Liu C, Guenther D, Omar M, Neunaber C, Krettek C, Jagodzinski M. Influence of biomechanical and biochemical stimulation on the proliferation and differentiation of bone marrow stromal cells seeded on polyurethane scaffolds. Exp Ther Med 2016; 11:2086-2094. [PMID: 27284290 PMCID: PMC4888012 DOI: 10.3892/etm.2016.3206] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Accepted: 02/19/2016] [Indexed: 02/06/2023] Open
Abstract
The aim of the present investigation was to compare the effects of cyclic compression, perfusion, dexamethasone (DEX) and bone morphogenetic protein-7 (BMP-7) on the proliferation and differentiation of human bone marrow stromal cells (hBMSCs) in polyurethane scaffolds in a perfusion bioreactor. Polyurethane scaffolds seeded with hBMSCs were cultured under six different conditions, as follows: 10% Cyclic compression at 0.5 and 5 Hz; 10 ml/min perfusion; 100 nM DEX; 100 ng/ml BMP-7; and 1 ml/min perfusion without mechanical and biochemical stimulation (control). On days 7 and 14, samples were tested for the following data: Cell proliferation; mRNA expression of Runx2, COL1A1 and osteocalcin; osteocalcin content; calcium deposition; and the equilibrium modulus of the tissue specimen. The results indicated that BMP-7 and 10 ml/min perfusion promoted cell proliferation, which was inhibited by 5 Hz cyclic compression and DEX. On day 7, the 5 Hz cyclic compression inhibited Runx2 expression, whereas the 0.5 Hz cyclic compression and BMP-7 upregulated the COL1A1 mRNA levels on day 7 and enhanced the osteocalcin expression on day 14. The DEX-treated hBMSCs exhibited downregulated osteocalcin expression. After 14 days, the BMP-7 group exhibited the highest calcium deposition, followed by the 0.5 Hz cyclic compression and the DEX groups. The equilibrium modulus of the engineered constructs significantly increased in the BMP-7, 0.5 Hz cyclic compression and DEX groups. In conclusion, the present results suggest that BMP-7 and perfusion enhance cell proliferation, whereas high frequency cyclic compression inhibits the proliferation and osteogenic differentiation of hBMSCs. Low frequency cyclic compression is more effective than DEX, but less effective compared with BMP-7 on the osteogenic differentiation of hBMSCs seeded on polyurethane scaffolds.
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Affiliation(s)
- Songsong Teng
- Department of Orthopedic Trauma, Hannover Medical School, 30625 Hannover, Germany
| | - Chaoxu Liu
- Department of Orthopedic Trauma, Hannover Medical School, 30625 Hannover, Germany
| | - Daniel Guenther
- Department of Orthopedic Trauma, Hannover Medical School, 30625 Hannover, Germany
| | - Mohamed Omar
- Department of Orthopedic Trauma, Hannover Medical School, 30625 Hannover, Germany
| | - Claudia Neunaber
- Department of Orthopedic Trauma, Hannover Medical School, 30625 Hannover, Germany
| | - Christian Krettek
- Department of Orthopedic Trauma, Hannover Medical School, 30625 Hannover, Germany
| | - Michael Jagodzinski
- Department of Orthopedic Trauma, Hannover Medical School, 30625 Hannover, Germany
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12
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Adolph EJ, Guo R, Pollins AC, Zienkiewicz K, Cardwell N, Davidson JM, Guelcher SA, Nanney LB. Injected biodegradable polyurethane scaffolds support tissue infiltration and delay wound contraction in a porcine excisional model. J Biomed Mater Res B Appl Biomater 2015; 104:1679-1690. [PMID: 26343927 DOI: 10.1002/jbm.b.33515] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 08/03/2015] [Accepted: 08/23/2015] [Indexed: 11/10/2022]
Abstract
The filling of wound cavities with new tissue is a challenge. We previously reported on the physical properties and wound healing kinetics of prefabricated, gas-blown polyurethane (PUR) scaffolds in rat and porcine excisional wounds. To address the capability of this material to fill complex wound cavities, this study examined the in vitro and in vivo reparative characteristics of injected PUR scaffolds employing a sucrose porogen. Using the porcine excisional wound model, we compared reparative outcomes to both preformed and injected scaffolds as well as untreated wounds at 9, 13, and 30 days after scaffold placement. Both injected and preformed scaffolds delayed wound contraction by 19% at 9 days and 12% at 13 days compared to nontreated wounds. This stenting effect proved transient since both formulations degraded by day 30. Both types of scaffolds significantly inhibited the undesirable alignment of collagen and fibroblasts through day 13. Injected scaffolds were highly compatible with sentinel cellular events of normal wound repair cell proliferation, apoptosis, and blood vessel density. The present study provides further evidence that either injected or preformed PUR scaffolds facilitate wound healing, support tissue infiltration and matrix production, delay wound contraction, and reduce scarring in a clinically relevant animal model, which underscores their potential utility as a void-filling platform for large cutaneous defects. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1679-1690, 2016.
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Affiliation(s)
- Elizabeth J Adolph
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, Tennessee
| | - Ruijing Guo
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, Tennessee
| | - Alonda C Pollins
- Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Katarzyna Zienkiewicz
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, Tennessee
| | - Nancy Cardwell
- Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jeffrey M Davidson
- Research Service, VA Tennessee Valley Healthcare System, Nashville, Tennessee.,Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Scott A Guelcher
- Department of Chemical and Biomolecular Engineering, Vanderbilt University, Nashville, Tennessee.,Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee.,Center for Bone Biology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Lillian B Nanney
- Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee. .,Department of Cell & Developmental Biology, Vanderbilt University Medical Center, Nashville, Tennessee.
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13
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Wang N, Grad S, Stoddart MJ, Niemeyer P, Südkamp NP, Pestka J, Alini M, Chen J, Salzmann GM. Bioreactor-Induced Chondrocyte Maturation Is Dependent on Cell Passage and Onset of Loading. Cartilage 2013; 4:165-76. [PMID: 26069659 PMCID: PMC4297099 DOI: 10.1177/1947603512471345] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To explore the effect of shifting in vitro culture conditions regarding cellular passage and onset of loading within matrix-associated bovine articular chondrocytes cultured under free-swelling and/or dynamical loading conditions on general chondrocyte maturation. METHODS Primary or passage 3 bovine chondrocytes were seeded in fibrin-polyurethane scaffolds. Constructs were cultured either free-swelling for 2 or 4 weeks, under direct mechanical loading for 2 or 4 weeks, or free swelling for 2 weeks followed by 2 weeks of loading. Samples were collected for glycosaminoglycan (GAG) quantification, mRNA expression of chondrogenic genes, immunohistochemistry, and histology. RESULTS Mechanical loading generally stimulated GAG synthesis, up-regulated chondrogenic genes, and improved the accumulation of matrix in cell-laden constructs when compared with free-swelling controls. Primary chondrocytes underwent more effective cartilage maturation when compared with passaged chondrocytes. Constructs of primary chondrocytes that were initially free-swelling followed by 2 weeks of mechanical load (delayed) had overall highest GAG with strongest responsiveness to load regarding matrix synthesis. Constructs that experienced the delayed loading regime also demonstrated most favorable chondrogenic gene expression profiles in both primary and third passage cells. Furthermore, most intense matrix staining and immunostaining of collagen type II and aggrecan were visualized in these constructs. CONCLUSIONS Primary chondrocytes were more effective than passage 3 chondrocytes when chondrogenesis was concerned. The most efficient chondrogenesis resulted from primary articular chondrocytes, which were initially free-swelling followed by a standardized loading protocol.
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Affiliation(s)
- Ning Wang
- Department of Orthopaedics, General Hospital of Chinese PLA, Beijing, People’s Republic of China,Department of Orthopaedic and Trauma Surgery, University Medical Center, Albert-Ludwigs University Freiburg, Freiburg, Germany,AO Research Institute Davos, Davos, Switzerland
| | | | | | - Philipp Niemeyer
- Department of Orthopaedic and Trauma Surgery, University Medical Center, Albert-Ludwigs University Freiburg, Freiburg, Germany
| | - Norbert P. Südkamp
- Department of Orthopaedic and Trauma Surgery, University Medical Center, Albert-Ludwigs University Freiburg, Freiburg, Germany
| | - Jan Pestka
- Department of Orthopaedic and Trauma Surgery, University Medical Center, Albert-Ludwigs University Freiburg, Freiburg, Germany
| | - Mauro Alini
- AO Research Institute Davos, Davos, Switzerland
| | - Jiying Chen
- Department of Orthopaedics, General Hospital of Chinese PLA, Beijing, People’s Republic of China
| | - Gian M. Salzmann
- Department of Orthopaedic and Trauma Surgery, University Medical Center, Albert-Ludwigs University Freiburg, Freiburg, Germany
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14
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Encalada-Diaz I, Cole BJ, MacGillivray JD, Ruiz-Suarez M, Kercher JS, Friel NA, Valero-Gonzalez F. Rotator cuff repair augmentation using a novel polycarbonate polyurethane patch: preliminary results at 12 months' follow-up. J Shoulder Elbow Surg 2011; 20:788-94. [PMID: 21106404 PMCID: PMC3872973 DOI: 10.1016/j.jse.2010.08.013] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Revised: 07/26/2010] [Accepted: 08/07/2010] [Indexed: 02/07/2023]
Abstract
BACKGROUND Preventing anatomic failure after rotator cuff repair (RCR) remains a challenge. Augmentation with a surgical mesh may permanently reinforce the repair and decrease failure rates. The purpose of this study is to assess the postoperative outcomes of open RCR augmented with a novel reticulated polycarbonate polyurethane patch. MATERIALS AND METHODS Ten patients with supraspinatus tendon tears underwent open RCR augmented with a polycarbonate polyurethane patch secured in a 6-point fixation construct placed over the repaired tendon. Patients were evaluated with preoperative and postoperative outcome measures, including the Simple Shoulder Test, visual analog pain scale, American Shoulder and Elbow Surgeons shoulder score, Cumulative Activities of Daily Living score, and University of California, Los Angeles shoulder scale, as well as range of motion. Postoperative magnetic resonance imaging was used to evaluate repair status. RESULTS Patients showed significant improvements in visual analog pain scale, Simple Shoulder Test, and American Shoulder and Elbow Surgeons shoulder scores at both 6 and 12 months postoperatively (P < .05 and P < .01, respectively). The University of California, Los Angeles postoperative score was good to excellent in 7 patients at 6 months and in 8 patients at 12 months. Range of motion in forward flexion, abduction, internal rotation, and external rotation was significantly improved at both 6 and 12 months postoperatively (P < .05 and P < .01, respectively). Magnetic resonance imaging at 12 months showed healing in 90%; one patient had a definitive persistent tear. We found no adverse events associated with the patch, including the absence of fibrosis, mechanical symptoms, or visible subacromial adhesions. DISCUSSION The polycarbonate polyurethane patch was designed to support tissue in growth and enhance healing as shown by preclinical animal studies. Clinically, the patch is well tolerated and shows promising efficacy, with a 10% retear rate at the 12-month time point.
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Affiliation(s)
- Ivan Encalada-Diaz
- Shoulder and Elbow Department, National Institute for Rehabilitation, Mexico City, Mexico
| | - Brian J. Cole
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA,Reprint requests: Brian J. Cole, MD, MBA, Department of Orthopaedic Surgery, Rush University Medical Center, 1611 W Harrison St, Ste 300, Chicago, IL 60612. (B.J. Cole)
| | | | - Michell Ruiz-Suarez
- Shoulder and Elbow Department, National Institute for Rehabilitation, Mexico City, Mexico
| | - James S. Kercher
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Nicole A. Friel
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
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