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A hybrid repair strategy for full-thickness cartilage defects: Long-term experimental study in eight horses.

Abstract: The objective of this study was to evaluate a non-resorbable implant for the focal repair of chondral defects in eight adult horses with 12-month follow-up. The bi-layered construct composed of a polycarbonate-urethane-urea biomaterial which was printed in 3D fashion onto a bone anchor was implanted into surgically created osteochondral defects into the femoropatellar joints of eight horses. The analysis of post-mortem outcomes were compared to defects treated with microfracture in the same animal on the contralateral femoropatellar jointfemoropatellar joint. The overall macroscopic scoring after 12 months yielded higher scores in the OCI-treated stifles compared to MF treatment (p = 0.09) with better quality and filling of the defect. Histology revealed good anchorage of repair tissue growing into the 3D structure of the implant and histopathology scoring for adjacent native cartilage showed no difference between groups. MRI and micro-CT showed overall less sclerotic reactions in the surrounding bone in the implant group and no foreign body reaction was detected. Biomechanical analysis of the repair tissue revealed a significantly higher peak modulus (p < 0.05) in the implant group (0.74 ± 0.45) compared to the microfracture control group (0.15 ± 0.11). Dynamic loading yielded higher values for the repair tissue overgrowing the implant group (0.23 ± 0.17) compared to the microfracture control (0.06 ± 0.06) (p < 0.05). The bi-layered osteochondral implant provided a safe implant for focal repair of full-thickness osteochondral defects, as no adverse reaction was seen within the joints and the level of degeneration of adjacent cartilage to the repair site was not different compared to that seen in defects treated with microfracture after 12 months.
Publication Date: 2024-09-18 PubMed ID: 39292194DOI: 10.1002/jor.25972Google Scholar: Lookup
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  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research study examined the use of a non-resorbable implant for the repair of cartilage defects in horses. Compared to traditional microfracture treatment, the implant resulted in higher quality repair, less bone reaction, and stronger biomechanical properties.

Research Context and Objective

  • This study evaluated a non-resorbable implant designed for focal (localised) repair of chondral (cartilage) defects.
  • The research involved a long-term experimental trial using eight adult horses, with an observation period lasting 12 months.
  • The main objective was to compare the efficacy and potential improvements offered by the new implant technique against the traditional microfracture treatment.

Methodology and Process

  • The implant used in this study was a bi-layered construct made up of a polycarbonate-urethane-urea biomaterial. This biomaterial was 3D printed onto a bone anchor for implantation.
  • The experiment involved surgically creating osteochondral defects in the femoropatellar joints of the horses. These defects were then treated with the above-mentioned bi-layered implant.
  • For comparison, defects were treated with traditional microfracture treatment on the same animal’s opposite femoropatellar joint.

Results and Findings

  • On macroscopic scoring, performed after 12 months, the implant treated defects scored higher than those treated through microfracture, denoting better quality and filling of the defect.
  • Microscopic examination revealed the repair tissues anchored well into the 3D structure of the implant.
  • Imaging tests (MRI and micro-CT scans) showed lesser sclerotic reactions (hardening of tissues) in the adjoining bones in the implant group. Additionally, no foreign body reaction was detected, indicating that the implants were well tolerated by the animals’ bodies.
  • Biomechanical testing showed that the elasticity or resistance of the repair tissue was significantly higher in the implant group, indicating stronger repair.
  • Furthermore, dynamic loading tests demonstrated improved mechanical performance of the repair tissues overgrowing the implant, as compared to the microfracture control treatment.

Conclusion

  • The bi-layered osteochondral implant has been effective and safe as a method for focal repair of osteochondral defects in horses. It showed no adverse reactions within the joints during the 12-month observation period.
  • In addition, the degeneration level of the adjacent cartilage to the repair site was not different compared to defects treated with the microfracture technique, suggesting that the implant did not cause harm to surrounding tissues.
  • These findings suggest that the implant may represent a promising alternative to conventional microfracture treatments for full-thickness osteochondral defects.

Cite This Article

APA
Fugazzola MC, De Ruijter M, Veraa S, Plomp S, van Buul W, Hermsen G, van Weeren R. (2024). A hybrid repair strategy for full-thickness cartilage defects: Long-term experimental study in eight horses. J Orthop Res. https://doi.org/10.1002/jor.25972

Publication

ISSN: 1554-527X
NlmUniqueID: 8404726
Country: United States
Language: English

Researcher Affiliations

Fugazzola, Maria C
  • Department of Clinical Sciences, Faculty of Veterinary Science, Utrecht University, Utrecht, The Netherlands.
De Ruijter, Mylène
  • Department of Clinical Sciences, Faculty of Veterinary Science, Utrecht University, Utrecht, The Netherlands.
  • Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands.
Veraa, Stefanie
  • Department of Clinical Sciences, Faculty of Veterinary Science, Utrecht University, Utrecht, The Netherlands.
Plomp, Saskia
  • Department of Clinical Sciences, Faculty of Veterinary Science, Utrecht University, Utrecht, The Netherlands.
  • Department of Orthopedics, University Medical Center Utrecht, Utrecht, The Netherlands.
van Buul, Ward
  • Joinstphere Company, Eindhoven, The Netherlands.
Hermsen, Gied
  • Joinstphere Company, Eindhoven, The Netherlands.
van Weeren, René
  • Department of Clinical Sciences, Faculty of Veterinary Science, Utrecht University, Utrecht, The Netherlands.

Grant Funding

  • Jointsphere B.V.

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