Repair of large osteochondritis dissecans lesions using a novel multilayered tissue engineered construct in an equine athlete.
Abstract: Osteochondral lesions resulting from osteochondritis dissecans are problematic to treat and present a significant challenge for clinicians. The aims of this study were to investigate the use of a scaffold-assisted microfracture approach, employing a novel, multilayered, collagen-based, osteochondral graft substitute in the treatment of severe osteochondritis dissecans of both lateral femoral trochlear ridges in an equine athlete, and to assess the potential of this novel scaffold to enhance repair of the osteochondral unit. A 15 month-old female filly presented with large osteochondritis dissecans lesions involving both femoral lateral trochlear ridges. After routine arthroscopic debridement and microfracture of the subchondral bone, multilayered osteochondral defect repair scaffolds were implanted into the fragmentation beds in both left and right femoropatellar joints via mini-arthrotomies. Exploratory arthroscopy 5 months postimplantation revealed smooth cartilaginous repair tissue, contiguous with the adjacent cartilage, covering the defect. At 22-month follow up, the filly had no signs of lameness and was exercising at her intended level. Radiographically, although still slightly flattened, the femoral trochlear ridges were smooth, with no evidence of osteoarthritis. Ultrasonographically, the defects were filled with bone and covered with an overlying cartilaginous layer, with the trochlear ridge contour almost entirely restored. This report demonstrates the effective clinical use of this novel, multilayered, osteochondral defect repair scaffold in the treatment of osteochondritis dissecans of an equine athlete. The successful repair achieved here using this novel scaffold in an equine patient with large bilateral lesions shows the potential for clinical translation in the treatment of human patients presenting with osteochondral defects. Copyright © 2016 John Wiley & Sons, Ltd.
Copyright © 2016 John Wiley & Sons, Ltd.
Publication Date: 2016-05-20 PubMed ID: 27198896DOI: 10.1002/term.2173Google Scholar: Lookup
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Summary
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The research study investigates the use of a novel scaffold-assisted microfracture technique to treat severe osteochondritis dissecans in an equine athlete using a multilayered, collagen-based graft substitute. The study concludes that this technique is effective, has potential for treating similar issues in humans and can improve the repair of the osteochondral unit.
Overview of the Research
- The research focuses on the development of a novel, scaffold-assisted microfracture approach using a multilayered, collagen-based, osteochondral graft substitute to treat serious cases of osteochondritis dissecans.
- Osteochondritis dissecans is a condition that develops in joints and causes symptoms such as pain and stiffness. It’s often difficult to treat, especially in athletes who require full recovery for optimal performance.
- This study was framed to explore the potential of the new scaffold in enhancing the repair of large and serious osteochondral damages.
Research Procedure
- The subject of the study was a 15 month-old filly that presented with large osteochondritis dissecans lesions on both of her femoral lateral trochlear ridges.
- The treatments were given through arthroscopic debridement and microfracture, after which the novel multilayered osteochondral defect repair scaffolds were implanted.
- Follow-up exams were conducted at a 5-month and 22-month mark to evaluate the success of the treatment procedure.
Results of the Study
- The 5-month follow-up revealed smooth, continuous repair tissue covering the defect in the joints.
- At the 22-month follow-up, it was observed that the fillies were not in discomfort and were exercising at their intended level.
- Radiographs reflected smooth femoral trochlear ridges, and there was no evidence of osteoarthritis. An ultrasonographic examination revealed that the defects had filled with bone and were covered with an overlying cartilaginous layer.
Significance of the Findings
- The positive findings from this research demonstrate the potential of using the multilayered, collagen-based, osteochondral graft substitute in treating cases of osteochondritis dissecans in humans as well.
- The study also indicates that the novel scaffold has the potential to drastically improve the outcomes of osteochondral unit repairs.
Cite This Article
APA
Stack JD, Levingstone TJ, Lalor W, Sanders R, Kearney C, O'Brien FJ, David F.
(2016).
Repair of large osteochondritis dissecans lesions using a novel multilayered tissue engineered construct in an equine athlete.
J Tissue Eng Regen Med, 11(10), 2785-2795.
https://doi.org/10.1002/term.2173 Publication
Researcher Affiliations
- University College Dublin Veterinary Hospital, University College Dublin, Ireland.
- Tissue Engineering Research Group, Department of Anatomy, Royal College of Surgeons in Ireland, Dublin, Ireland.
- Trinity Centre for Bioengineering, Trinity College Dublin, Ireland.
- Advanced Materials and Bioengineering Research (AMBER) Centre, RCSI & TCD, Dublin, Ireland.
- W. Lalor Equine Sports Medicine, Clonmel, Co. Tipperary, Ireland.
- Chiltern Equine Clinic, Blueberry Farm Hospital, Warfield, Berkshire, UK.
- University College Dublin Veterinary Hospital, University College Dublin, Ireland.
- Tissue Engineering Research Group, Department of Anatomy, Royal College of Surgeons in Ireland, Dublin, Ireland.
- Trinity Centre for Bioengineering, Trinity College Dublin, Ireland.
- Advanced Materials and Bioengineering Research (AMBER) Centre, RCSI & TCD, Dublin, Ireland.
- Bjerke Dyrehospital - En Rikstotoklinikk, Oslo, Norway.
MeSH Terms
- Animals
- Arthroscopy
- Cartilage, Articular / pathology
- Female
- Horses
- Osteochondritis Dissecans / diagnostic imaging
- Osteochondritis Dissecans / pathology
- Osteochondritis Dissecans / therapy
- Patellofemoral Joint / diagnostic imaging
- Postoperative Care
- Regeneration / physiology
- Synovial Fluid / metabolism
- Tissue Engineering / methods
- Tissue Scaffolds / chemistry
Citations
This article has been cited 6 times.- Levingstone TJ, Sheehy EJ, Moran CJ, Cunniffe GM, Diaz Payno PJ, Brady RT, Almeida HV, Carroll SF, O'Byrne JM, Kelly DJ, Brama PA, O' Brien FJ. Evaluation of a co-culture of rapidly isolated chondrocytes and stem cells seeded on tri-layered collagen-based scaffolds in a caprine osteochondral defect model. Biomater Biosyst 2022 Dec;8:100066.
- Brady RT, O'Brien FJ, Hoey DA. The Impact of the Extracellular Matrix Environment on Sost Expression by the MLO-Y4 Osteocyte Cell Line. Bioengineering (Basel) 2022 Jan 13;9(1).
- Levingstone TJ, Moran C, Almeida HV, Kelly DJ, O'Brien FJ. Layer-specific stem cell differentiation in tri-layered tissue engineering biomaterials: Towards development of a single-stage cell-based approach for osteochondral defect repair. Mater Today Bio 2021 Sep;12:100173.
- 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.
- Meng X, Grad S, Wen C, Lai Y, Alini M, Qin L, Wang X. An impaired healing model of osteochondral defect in papain-induced arthritis. J Orthop Translat 2021 Jan;26:101-110.
- Bourebaba L, Röcken M, Marycz K. Osteochondritis dissecans (OCD) in Horses - Molecular Background of its Pathogenesis and Perspectives for Progenitor Stem Cell Therapy. Stem Cell Rev Rep 2019 Jun;15(3):374-390.
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