A short-term evaluation of a thermoplastic polyurethane implant for osteochondral defect repair in an equine model.
Abstract: Cartilage repair remains a major challenge and treatment of (osteo)chondral defects generally results in poor quality fibrous repair tissue. Our approach aims to address some of the major biomechanical issues encountered in scaffold-based cartilage repair, such as insufficient stiffness of the scaffolds, step formation at the interface with the native tissue and inadequate integration with the original tissue. Two osteochondral defects were created on the medial femoral trochlear ridge in each stifle of six Shetland ponies. The defects were filled with a bi-layered implant consisting of a polyetherketoneketone (PEKK) bone anchor and a polyurethane elastomer. The defects in the contralateral joint served as unfilled controls. After 12 weeks, the ponies were euthanased and tissues were evaluated macroscopically and using micro-computed tomography, histology and immunohistochemistry. Post-operative recovery was good in all ponies and minimal lameness was observed. After 12 weeks, the proximally located plug was partially covered (mean±standard deviation [SD] percentage surface area covered 72.5±19.7%) and the distal plug was nearly completely covered (mean±SD percentage surface area covered 98.5±6.1%) with stiff and smooth repair tissue. Histology and immunohistochemistry confirmed that the repair tissue was well connected to the native cartilage but contained negligible amounts of collagen type II and glycosaminoglycans (GAGs). The repair tissue was stiff and fibrous in nature and presented a nearly flush surface with the surrounding native cartilage distally. This approach therefore resolves a number of issues related to scaffold-based cartilage repair and compares favourably with results of several other studies in large animal models. However, long-term follow-up is needed to evaluate the true potential of this type of implant.
Copyright © 2019 Elsevier Ltd. All rights reserved.
Publication Date: 2019-07-20 PubMed ID: 31492385DOI: 10.1016/j.tvjl.2019.105340Google Scholar: Lookup
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- Evaluation Study
- Journal Article
Summary
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This research explores a novel method of cartilage repair, using a layered implant of different materials. In an equine model, this new approach showed promise by addressing some biomechanical issues often seen in traditional scaffold-based cartilage repair processes. However, further long-term study is necessary to evaluate the full potential of this innovation.
Objective and Methods Used in the Study
- The aim of the research was to address issues encountered with traditional scaffold-based cartilage repair, including not having enough stiffness, forming steps at the interface with original tissue, and lacking adequate integration.
- For this purpose, two osteochondral defects were developed on the medial femoral trochlear ridge in the stifle (a joint in the hind leg) of six Shetland ponies.
- The defects were filled with a bi-layered implant composed of a Polyetherketoneketone (PEKK) bone anchor and a polyurethane elastomer. Defects in the opposing joint were left unfilled to serve as control.
Observations and Findings
- After 12 weeks, all six ponies showed good recovery with only minimal lameness observed. The bone anchors were partially or almost entirely covered with repair tissue depending on their location.
- The repair tissue was found to be well-connected to the native cartilage but contained very little amounts of collagen type II and glycosaminoglycans (GAGs), which are key components of healthy cartilage.
- The new tissue tended to be stiff and fibrous, with a smooth and flush surface that matched well with the surrounding cartilage. This addresses the previous issue of step formation at the interface seen in traditional scaffold-based repair.
Conclusions and Future Recommendations
- This new method of cartilage repair shows promise in resolving some of the biomechanical issues presented by traditional scaffold-based techniques.
- While short-term results are promising, the authors recommend further long-term studies to fully evaluate the potential of this bi-layered PEKK and polyurethane elastomer implant model.
Cite This Article
APA
Korthagen NM, Brommer H, Hermsen G, Plomp SGM, Melsom G, Coeleveld K, Mastbergen SC, Weinans H, van Buul W, van Weeren PR.
(2019).
A short-term evaluation of a thermoplastic polyurethane implant for osteochondral defect repair in an equine model.
Vet J, 251, 105340.
https://doi.org/10.1016/j.tvjl.2019.105340 Publication
Researcher Affiliations
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, The Netherlands; Department of Orthopaedics, Regenerative Medicine Center, University Medical Center Utrecht, Utrecht University, The Netherlands.
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, The Netherlands.
- JointSphere BV, Eindhoven, The Netherlands.
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, The Netherlands.
- JointSphere BV, Eindhoven, The Netherlands.
- Department of Rheumatology and Clinical Immunology, Regenerative Medicine Center, University Medical Center Utrecht, Utrecht University, The Netherlands.
- Department of Rheumatology and Clinical Immunology, Regenerative Medicine Center, University Medical Center Utrecht, Utrecht University, The Netherlands.
- Department of Orthopaedics, Regenerative Medicine Center, University Medical Center Utrecht, Utrecht University, The Netherlands.
- JointSphere BV, Eindhoven, The Netherlands.
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, The Netherlands. Electronic address: r.vanweeren@uu.nl.
MeSH Terms
- Animals
- Cartilage, Articular / injuries
- Cartilage, Articular / surgery
- Cells, Cultured
- Female
- Femur
- Horses
- Implants, Experimental
- Male
- Materials Testing / veterinary
- Models, Animal
- Polymers
- Polyurethanes
- Tissue Engineering / methods
- Tissue Scaffolds
Citations
This article has been cited 8 times.- Bianchi E, Ruggeri M, Vigani B, Del Favero E, Ricci C, Boselli C, Icaro Cornaglia A, Viseras C, Rossi S, Sandri G. Cerium Oxide and Chondroitin Sulfate Doped Polyurethane Scaffold to Bridge Tendons.. ACS Appl Mater Interfaces 2023 Jun 7;15(22):26510-26524.
- Chen R, Pye JS, Li J, Little CB, Li JJ. Multiphasic scaffolds for the repair of osteochondral defects: Outcomes of preclinical studies.. Bioact Mater 2023 Sep;27:505-545.
- Wang Y, Chen Y, Wei Y. Osteoarthritis animal models for biomaterial-assisted osteochondral regeneration.. Biomater Transl 2022;3(4):264-279.
- Lim YY, Miskon A, Zaidi AMA. Structural Strength Analyses for Low Brass Filler Biomaterial with Anti-Trauma Effects in Articular Cartilage Scaffold Design.. Materials (Basel) 2022 Jun 24;15(13).
- Ai C, Lee YHD, Tan XH, Tan SHS, Hui JHP, Goh JC. Osteochondral tissue engineering: Perspectives for clinical application and preclinical development.. J Orthop Translat 2021 Sep;30:93-102.
- Gonçalves AM, Moreira A, Weber A, Williams GR, Costa PF. Osteochondral Tissue Engineering: The Potential of Electrospinning and Additive Manufacturing.. Pharmaceutics 2021 Jun 29;13(7).
- Grzeskowiak RM, Alghazali KM, Hecht S, Donnell RL, Doherty TJ, Smith CK, Anderson DE, Biris AS, Adair HS. Influence of a novel scaffold composed of polyurethane, hydroxyapatite, and decellularized bone particles on the healing of fourth metacarpal defects in mares.. Vet Surg 2021 Jul;50(5):1117-1127.
- Fugazzola MC, van Weeren PR. Surgical osteochondral defect repair in the horse-a matter of form or function?. Equine Vet J 2020 Jul;52(4):489-499.
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