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Home / Equine Research Bank / Cartilage / Two-Year Evaluation of Osteochondral Repair with a Novel Bip...
Cartilage2016; 8(4); 406-416; doi: 10.1177/1947603516675913

Two-Year Evaluation of Osteochondral Repair with a Novel Biphasic Graft Saturated in Bone Marrow in an Equine Model.

Abstract: Objective To evaluate a biphasic cartilage repair device (CRD) for feasibility of arthroscopic implantation, safety, biocompatibility, and efficacy for long-term repair of large osteochondral defects. Methods The CRD was press-fit into defects (10 mm diameter, 10 mm deep) created in the femoral trochlea of 12 horses. In the contralateral limb, 10 mm diameter full-thickness chondral defects were treated with microfracture (MFX). Radiographs were obtained pre- and postoperatively, and at 4, 12, and 24 months. Repeat arthroscopy was performed at 4 and 12 months. Gross assessment, histology, mechanical testing, and magnetic resonance imaging (MRI) were performed at 24 months. Results The CRD was easily placed arthroscopically. There was no evidence of joint infection, inflammation, or degeneration. CRD-treated defects had significantly more sclerosis compared to MFX early ( P = 0.0006), but was not different at 24 months. CRD had better arthroscopic scores at 4 months compared to MFX ( P = 0.0069). At 24 months, there was no difference in repair tissue on histology or mechanical testing. Based on MRI, CRD repair tissue had less proteoglycan (deep P = 0.027, superficial P = 0.015) and less organized collagen (deep P = 0.028) compared to MFX. Cartilage surrounding MFX defects had more fissures compared to CRD. Conclusion The repair tissue formed after CRD treatment of a large osteochondral lesion is fibrocartilage similar to that formed in simple chondral defects treated with MFX. The CRD can be easily placed arthroscopically, is safe, and biocompatible for 24 months. The CRD results in improved early arthroscopic repair scores and may limit fissure formation in adjacent cartilage.
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Publication Date: 2016-11-04 PubMed ID: 28934879PubMed Central: PMC5613894DOI: 10.1177/1947603516675913Google 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.

This research focuses on the evaluation of a cartilage repair device (CRD) for its arthroscopic implantation feasibility, safety, biocompatibility, and effectiveness in repairing large osteochondral defects over a two-year period using an equine model.

Methods Used in the Study

  • The study revolves around a biphasic CRD, which was press-fit into defects that were created intentionally on the femoral trochlea of 12 horses. The defects measured 10mm in diameter and were 10mm deep.
  • The researchers also had a control group where chondral defects of the same size were treated using the microfracture (MFX) technique on the contralateral limb of the same horse.
  • Several radiographs were taken before the operation, after the operation, and at intervals of 4, 12, and 24 months after the operation. Repeat arthroscopy was performed at 4 and 12 months.
  • A comprehensive assessment of the repair was conducted at the end of 24 months, which includes a gross assessment, histology, mechanical testing, and an MRI scan.

Results Obtained from the Study

  • The arthroscopic placement of the CRD seemed convenient and devoid of any evident risks of joint infection, inflammation, or degeneration.
  • In comparison to MFX treatments, the defects treated with the CRD showed significantly more sclerosis at an early stage, but there was no discernible difference after 24 months.
  • The study also reveals that the CRD had better arthroscopic scores at 4 months compared to the MFX treatment, hinting at superior early repair results.
  • However, there wasn’t a significant difference in the repair tissue established through the two methods based on mechanic testing and histology at the end of 24 months.
  • Nevertheless, the MRI scans revealed lesser proteoglycan in the repair tissue established using the CRD and less organized collagen when compared with that created using MFX.
  • The report also suggests that the cartilage surrounding the MFX-treated defects exhibited more fissures than those treated by the CRD.

Conclusion of the Study

  • The fibrocartilage repair tissue formed after treating large osteochondral lesions with a CRD was found to be similar to that formed in simple chondral defects treated using MFX.
  • One of the major advantages, as suggested by the research, is that a CRD can be easily placed arthroscopically, and it is safe and compatible for a period of 24 months. Furthermore, it offers better early arthroscopic repair results and may also limit fissural formation in adjacent cartilage.

Cite This Article

APA
McCarrel TM, Pownder SL, Gilbert S, Koff MF, Castiglione E, Saska RA, Bradica G, Fortier LA. (2016). Two-Year Evaluation of Osteochondral Repair with a Novel Biphasic Graft Saturated in Bone Marrow in an Equine Model. Cartilage, 8(4), 406-416. https://doi.org/10.1177/1947603516675913

Publication

Cartilage
ISSN: 1947-6043
NlmUniqueID: 101518378
Country: United States
Language: English
Volume: 8
Issue: 4
Pages: 406-416

Researcher Affiliations

McCarrel, Taralyn M
  • 1 Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, USA.
  • Department of Large Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, FL, USA.
Pownder, Sarah L
  • 2 Hospital for Special Surgery, New York, NY, USA.
Gilbert, Susannah
  • 2 Hospital for Special Surgery, New York, NY, USA.
Koff, Matthew F
  • 2 Hospital for Special Surgery, New York, NY, USA.
Castiglione, Emme
  • 3 DSM Biomedical d/b/a Kensey Nash Corporation, Exton, PA, USA.
Saska, Ryan A
  • 3 DSM Biomedical d/b/a Kensey Nash Corporation, Exton, PA, USA.
Bradica, Gino
  • 3 DSM Biomedical d/b/a Kensey Nash Corporation, Exton, PA, USA.
Fortier, Lisa A
  • 1 Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, USA.

Conflict of Interest Statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Fortier was on the Board of Scientific Advisors to Kensey Nash during the time this project was completed. Castiglione, Bradica, and Saska are employees of Kensey Nash Corporation. The HSS MRI Laboratory (Pownder and Koff) receives institutional research support from General Electric Healthcare. McCarrel and Gilbert have no conflicts of interest to report.

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