Tissue-Engineered Osteochondral Allograft Versus Fresh Osteochondral Allograft: Comparable Cartilage and Subchondral Bone Repair in a 14-Month Equine Osteochondral Defect Model.
Abstract: Fresh osteochondral allograft (OCA) transplantation effectively repairs cartilage and subchondral bone; however, the persisting shortage of available donor OCAs and their short shelf-life make scheduling surgeries and meeting patient demand challenging. Attempts have been made to develop tissue-engineered solutions to address the limitations of OCA; nonetheless, these have failed to progress beyond the preclinical stage. Objective: To assess the safety and efficacy of a tissue-engineered osteochondral allograft (TE-OCA) as compared with equine OCA in an equine osteochondral defect model. Methods: Controlled laboratory study. Methods: Bilateral critical-size (10 × 7.0-7.5 mm) osteochondral defects were surgically created on the femoral medial trochlear ridge of healthy, skeletally mature horses (2-5 years; n = 8). A TE-OCA was placed into 1 defect, and an OCA was placed into the contralateral defect as a positive control. At surgery, throughout the study, and at sacrifice (14 months), quantitative evaluation of lameness and synovial fluid composition was obtained, while radiographs, arthroscopies (4, 10, and 12 months), or gross images, and synovial membrane were qualitatively scored. Postmortem, joints and grafts were evaluated using T1- and T2-weighted magnetic resonance imaging, quantitative computed tomography, and biomechanical testing. Histology and immunohistochemistry were performed on osteochondral blocks that were qualitatively scored. Results: TE-OCA exhibited better cartilage-cartilage integration on histology (97.1 ± 7.6 vs 41.7 ± 45; = .03) and a lower T1ρ quantitative score (65.6 ± 10.6 vs 72.8 ± 5.5; = .03) than OCA, indicative of an intact regeneration of cartilage matrix. TE-OCA matured in vivo, with biomechanical instantaneous and equilibrium compressive moduli improving to match that of OCA (1.74 ± 0.7 vs 1.96 ± 1.2 MPa [≥.999], and 0.39 ± 0.2 vs 0.18 ± 0.2 MPa [ = .22], respectively). There were no differences between total radiographic scores (3.6 ± 2.7 vs 2.1 ± 1.7; = .9), total International Cartilage Repair Society cartilage scores (5.1 ± 4.9 vs 2.8 ± 0.8; = .6), and total morphologic MRI scores (8.9 ± 2.8 vs 6.2 ± 3.7; = .3) at the study end. No off-target effects were seen. Conclusions: TE-OCA is comparable to OCA in multiple safety and efficacy measures of osteochondral defect repair. Conclusions: This preclinical study indicates that TE-OCA provides an alternative solution to OCA and addresses the long-standing issues of limited supply and short shelf-life.
Publication Date: 2026-02-10 PubMed ID: 41665486DOI: 10.1177/03635465251409083Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
- Comparative Study
Summary
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Overview
- This study compares a tissue-engineered osteochondral allograft (TE-OCA) to fresh osteochondral allografts (OCA) for repairing cartilage and subchondral bone defects in horse knee joints.
- The research finds that TE-OCA performs similarly to fresh OCA in safety and effectiveness, offering a potential solution to donor shortages and storage limitations.
Introduction
- Osteochondral allografting (OCA) is a surgical method used to repair cartilage and underlying bone defects, but it suffers from limited donor availability and a short shelf-life.
- Tissue-engineered osteochondral allografts (TE-OCA) have been proposed as an alternative but previously failed to progress beyond preclinical testing.
- The objective of the study was to compare the safety and efficacy of TE-OCA with fresh OCA using an equine (horse) model of osteochondral defects.
Methods
- Subjects: 8 healthy, skeletally mature horses aged 2-5 years.
- Defect creation: Critical-size osteochondral defects (10 × 7.0-7.5 mm) were surgically made bilaterally on the medial trochlear ridge of each horse’s femur.
- Treatment: Each horse received a TE-OCA in one defect and a fresh OCA in the contralateral defect.
- Evaluation timeline: Measurements were taken at surgery, at 4, 10, and 12 months via arthroscopy, and at sacrifice at 14 months.
- Assessments included:
- Lameness evaluation and synovial fluid composition for inflammation and joint health
- Radiographs and arthroscopic scoring to estimate joint repair quality
- Gross examination and synovial membrane evaluation at termination
- Postmortem MRI (T1 and T2 weighted), quantitative computed tomography (CT), biomechanical testing of graft mechanical properties
- Histology and immunohistochemistry on tissue blocks to score cartilage and integration quality
Results
- Histological cartilage-cartilage integration: TE-OCA showed significantly better integration (mean score ~97.1) compared to OCA (mean score ~41.7), indicating stronger bonding between graft and native cartilage.
- T1ρ quantitative MRI score: Lower values for TE-OCA (65.6) vs. OCA (72.8) suggest better preservation and regeneration of cartilage matrix.
- Biomechanical properties: TE-OCA grafts matured in the body; their instantaneous and equilibrium compressive moduli approximated values of fresh OCA, showing functional mechanical repair.
- Radiographic scores and cartilage repair scores: No significant differences between TE-OCA and OCA indicating comparable bone healing and cartilage restoration.
- MRI morphology: Similar overall scores for repair quality between TE-OCA and OCA.
- Safety: No off-target complications or adverse effects detected with TE-OCA use.
Conclusions
- TE-OCA demonstrated comparable outcomes to fresh OCA across multiple evaluation domains including histology, MRI, biomechanics, and safety.
- This suggests that TE-OCA is a viable alternative graft with potential advantages such as:
- Overcoming the issue of limited donor tissue supply.
- Possibly providing grafts with extended shelf-life compared to fresh OCA.
- Thus, TE-OCA could facilitate more flexible surgical scheduling and broader patient accessibility.
- Overall, this preclinical equine model study provides important evidence supporting further development and clinical translation of tissue-engineered osteochondral grafts.
Cite This Article
APA
Keller LE, Kelly TN, Chevalier JM, Jung HJ, Pearson GB, Begum L, Beane OS, Bhumiratana S, Fortier LA.
(2026).
Tissue-Engineered Osteochondral Allograft Versus Fresh Osteochondral Allograft: Comparable Cartilage and Subchondral Bone Repair in a 14-Month Equine Osteochondral Defect Model.
Am J Sports Med, 54(3), 622-634.
https://doi.org/10.1177/03635465251409083 Publication
Researcher Affiliations
- Cornell University College of Veterinary Medicine, Ithaca, New York, USA.
- EpiBone, Inc, New York, New York, USA.
- Cornell University College of Veterinary Medicine, Ithaca, New York, USA.
- EpiBone, Inc, New York, New York, USA.
- Cornell University College of Veterinary Medicine, Ithaca, New York, USA.
- Cornell University College of Veterinary Medicine, Ithaca, New York, USA.
- EpiBone, Inc, New York, New York, USA.
- EpiBone, Inc, New York, New York, USA.
- Cornell University College of Veterinary Medicine, Ithaca, New York, USA.
MeSH Terms
- Animals
- Horses
- Tissue Engineering / methods
- Cartilage, Articular / surgery
- Cartilage, Articular / injuries
- Bone Transplantation / methods
- Allografts
- Transplantation, Homologous
- Magnetic Resonance Imaging
- Disease Models, Animal
- Femur / surgery
Conflict of Interest Statement
One or more of the authors has declared the following potential conflict of interest or source of funding: This research was funded by EpiBone Inc for independent testing and assessment. As part of the research contracting fee, salaries of L.E.K., J.M.C., G.B.P., L.B., and L.A.F. were included as part of the research budget. At the time of research performance, T.N.K., H.J.J., O.S.B., and S.B. were the employees of EpiBone Inc, and any work-related traveling was paid for by EpiBone Inc. S.B. was on the board of directors of EpiBone Inc during the research performance. T.N.K., H.J.J., O.S.B., and S.B. hold stocks or bonds as part of the employee agreement of EpiBone Inc. EpiBone Inc exclusively licensed a patent relevant to the study from Columbia University. L.A.F. is a paid consultant to Arthrex, Inc. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.
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