Skip to main content

Advertisement

SpringerLink
Log in

Oligo[poly(ethylene glycol)fumarate] Hydrogel Enhances Osteochondral Repair in Porcine Femoral Condyle Defects

  • Symposium: Osteochondritis Dissecans
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Management of osteochondritis dissecans remains a challenge. Use of oligo[poly(ethylene glycol)fumarate] (OPF) hydrogel scaffold alone has been reported in osteochondral defect repair in small animal models. However, preclinical evaluation of usage of this scaffold alone as a treatment strategy is limited.

Questions/purposes

We therefore (1) determined in vitro pore size and mechanical stiffness of freeze-dried and rehydrated freeze-dried OPF hydrogels, respectively; (2) assessed in vivo gross defect filling percentage and histologic findings in defects implanted with rehydrated freeze-dried hydrogels for 2 and 4 months in a porcine model; (3) analyzed highly magnified histologic sections for different types of cartilage repair tissues, subchondral bone, and scaffold; and (4) assessed neotissue filling percentage, cartilage phenotype, and Wakitani scores.

Methods

We measured pore size of freeze-dried OPF hydrogel scaffolds and mechanical stiffness of fresh and rehydrated forms. Twenty-four osteochondral defects from 12 eight-month-old micropigs were equally divided into scaffold and control (no scaffold) groups. Gross and histologic examination, one-way ANOVA, and one-way Mann-Whitney U test were performed at 2 and 4 months postoperatively.

Results

Pore sizes ranged from 20 to 433 μm in diameter. Rehydrated freeze-dried scaffolds had mechanical stiffness of 1 MPa. The scaffold itself increased percentage of neotissue filling at both 2 and 4 months to 58% and 54%, respectively, with hyaline cartilage making up 39% of neotissue at 4 months.

Conclusions

Rehydrated freeze-dried OPF hydrogel can enhance formation of hyaline-fibrocartilaginous mixed repair tissue of osteochondral defects in a porcine model.

Clinical Relevance

Rehydrated freeze-dried OPF hydrogel alone implanted into cartilage defects is insufficient to generate a homogeneously hyaline cartilage repair tissue, but its spacer effect can be enhanced by other tissue-regenerating mediators.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3A–D
Fig. 4
Fig. 5A–D
Fig. 6A–D
Fig. 7A–D
Fig. 8A–D
Fig. 9A–D
Fig. 10
Fig. 11
Fig. 12

Similar content being viewed by others

References

  1. Chu CR, Szczodry M, Bruno S. Animal models for cartilage regeneration and repair. Tissue Eng Part B Rev. 2010;16:105–115.

    Article  PubMed  Google Scholar 

  2. Crawford DC, Safran MR. Osteochondritis dissecans of the knee. J Am Acad Orthop Surg. 2006;14:90–100.

    PubMed  Google Scholar 

  3. Ferkel RD, Zanotti RM, Komenda GA, Sgaglione NA, Cheng MS, Applegate GR, Dopirak RM. Arthroscopic treatment of chronic osteochondral lesions of the talus: long-term results. Am J Sports Med. 2008;36:1750–1762.

    Article  PubMed  Google Scholar 

  4. Filová E, Rampichová M, Handl M, Lytvynets A, Halouzka R, Usvald D, Hlucilová J, Procházka R, Dezortová M, Rolencová E, Kostáková E, Trc T, Stastný E, Kolácná L, Hájek M, Motlík J, Amler E. Composite hyaluronate-type I collagen-fibrin scaffold in the therapy of osteochondral defects in miniature pigs. Physiol Res. 2007;56(suppl 1):S5–S16.

    PubMed  Google Scholar 

  5. Flynn JM, Kocher MS, Ganley TJ. Osteochondritis dissecans of the knee. J Pediatr Orthop. 2004;24:434–443.

    Article  PubMed  Google Scholar 

  6. Freemont AJ, Hoyland J. Lineage plasticity and cell biology of fibrocartilage and hyaline cartilage: its significance in cartilage repair and replacement. Eur J Radiol. 2006;57:32–36.

    Article  PubMed  Google Scholar 

  7. Gobbi A, Nunag P, Malinowski K. Treatment of full thickness chondral lesions of the knee with microfracture in a group of athletes. Knee Surg Sports Traumatol Arthrosc. 2005;13:213–221.

    Article  PubMed  Google Scholar 

  8. Gotterbarm T, Richter W, Jung M, Berardi Vilei S, Mainil-Varlet P, Yamashita T, Breusch SJ. An in vivo study of a growth-factor enhanced, cell free, two-layered collagen-tricalcium phosphate in deep osteochondral defects. Biomaterials. 2006;27:3387–3395.

    Article  PubMed  CAS  Google Scholar 

  9. Gudas R, Kalesinskas RJ, Kimtys V, Stankevicius E, Toliusis V, Bernotavicius G, Smailys A. A prospective randomized clinical study of mosaic osteochondral autologous transplantation versus microfracture for the treatment of osteochondral defects in the knee joint in young athletes. Arthroscopy. 2005;21:1066–1075.

    Article  PubMed  Google Scholar 

  10. Guettler JH, Demetropoulos CK, Yang KH, Jurist KA. Osteochondral defects in the human knee: influence of defect size on cartilage rim stress and load redistribution to surrounding cartilage. Am J Sports Med. 2004;32:1451–1458.

    Article  PubMed  Google Scholar 

  11. Guettler JH, Demetropoulos CK, Yang KH, Jurist KA. Dynamic evaluation of contact pressure and the effects of graft harvest with subsequent lateral release at osteochondral donor sites in the knee. Arthroscopy. 2005;21:715–720.

    Article  PubMed  Google Scholar 

  12. Guo X, Park H, Liu G, Liu W, Cao Y, Tabata Y, Kasper FK, Mikos AG. In vitro generation of an osteochondral construct using injectable hydrogel composites encapsulating rabbit marrow mesenchymal stem cells. Biomaterials. 2009;30:2741–2752.

    Article  PubMed  CAS  Google Scholar 

  13. Guo X, Park H, Young S, Kretlow JD, van den Beucken JJ, Baggett LS, Tabata Y, Kasper FK, Mikos AG, Jansen JA. Repair of osteochondral defects with biodegradable hydrogel composites encapsulating marrow mesenchymal stem cells in a rabbit model. Acta Biomater. 2010;6:39–47.

    Article  PubMed  CAS  Google Scholar 

  14. Hao T, Wen N, Cao JK, Wang HB, Lü SH, Liu T, Lin QX, Duan CM, Wang CY. The support of matrix accumulation and the promotion of sheep articular cartilage defects repair in vivo by chitosan hydrogels. Osteoarthritis Cartilage. 2010;18:257–265.

    Article  PubMed  CAS  Google Scholar 

  15. Harris JD, Siston RA, Brophy RH, Lattermann C, Carey JL, Flanigan DC. Failures, re-operations, and complications after autologous chondrocyte implantation—a systematic review. Osteoarthritis Cartilage. 2011;19:779–791.

    Article  PubMed  CAS  Google Scholar 

  16. Hayan R, Phillipe G, Ludovic S, Claude K, Jean-Michel C. Juvenile osteochondritis of femoral condyles: treatment with transchondral drilling: analysis of 40 cases. J Child Orthop. 2010;4:39–44.

    Article  PubMed  Google Scholar 

  17. Holland TA, Bodde EW, Baggett LS, Tabata Y, Mikos AG, Jansen JA. Osteochondral repair in the rabbit model utilizing bilayered, degradable oligo(poly(ethylene glycol) fumarate) hydrogel scaffolds. J Biomed Mater Res A. 2005;75:156–167.

    PubMed  Google Scholar 

  18. Holland TA, Bodde EW, Cuijpers VM, Baggett LS, Tabata Y, Mikos AG, Jansen JA. Degradable hydrogel scaffolds for in vivo delivery of single and dual growth factors in cartilage repair. Osteoarthritis Cartilage. 2007;15:187–197.

    Article  PubMed  CAS  Google Scholar 

  19. Holland TA, Tabata Y, Mikos AG. In vitro release of transforming growth factor-beta 1 from gelatin microparticles encapsulated in biodegradable, injectable oligo(poly(ethylene glycol) fumarate) hydrogels. J Control Release. 2003;91:299–313.

    Article  PubMed  CAS  Google Scholar 

  20. Holland TA, Tabata Y, Mikos AG. Dual growth factor delivery from degradable oligo(poly(ethylene glycol) fumarate) hydrogel scaffolds for cartilage tissue engineering. J Control Release. 2005;101:111–125.

    Article  PubMed  CAS  Google Scholar 

  21. Holland TA, Tessmar JK, Tabata Y, Mikos AG. Transforming growth factor-beta 1 release from oligo(poly(ethylene glycol) fumarate) hydrogels in conditions that model the cartilage wound healing environment. J Control Release. 2004;94:101–114.

    Article  PubMed  CAS  Google Scholar 

  22. Hunziker EB, Rosenberg LC. Repair of partial-thickness defects in articular cartilage: cell recruitment from the synovial membrane. J Bone Joint Surg Am. 1996;78:721–733.

    PubMed  CAS  Google Scholar 

  23. Hwang CM, Sant S, Masaeli M, Kachouie NN, Zamanian B, Lee SH, Khademhosseini A. Fabrication of three-dimensional porous cell-laden hydrogel for tissue engineering. Biofabrication. 2010;2:035003.

    Article  PubMed  Google Scholar 

  24. Jackson DW, Lalor PA, Aberman HM, Simon TM. Spontaneous repair of full-thickness defects of articular cartilage in a goat model: a preliminary study. J Bone Joint Surg Am. 2001;83:53–64.

    Article  PubMed  Google Scholar 

  25. Jiang CC, Chiang H, Liao CJ, Lin YJ, Kuo TF, Shieh CS, Huang YY, Tuan RS. Repair of porcine articular cartilage defect with a biphasic osteochondral composite. J Orthop Res. 2007;25:1277–1290.

    Article  PubMed  CAS  Google Scholar 

  26. Jo S, Shin H, Shung AK, Fisher JP, Mikos AG. Synthesis and characterization of oligo(poly(ethylene glycol) fumarate) macromer. Macromolecules 2001;34:2839–2844.

    Article  CAS  Google Scholar 

  27. Kasper FK, Jerkins E, Tanahashi K, Barry MA, Tabata Y, Mikos AG. Characterization of DNA release from composites of oligo(poly(ethylene glycol) fumarate) and cationized gelatin microspheres in vitro. J Biomed Mater Res A. 2006;78:823–835.

    PubMed  Google Scholar 

  28. Kasper FK, Kushibiki T, Kimura Y, Mikos AG, Tabata Y. In vivo release of plasmid DNA from composites of oligo(poly(ethylene glycol)fumarate) and cationized gelatin microspheres. J Control Release. 2005;107:547–561.

    Article  PubMed  CAS  Google Scholar 

  29. Kasper FK, Seidlits SK, Tang A, Crowther RS, Carney DH, Barry MA, Mikos AG. In vitro release of plasmid DNA from oligo(poly(ethylene glycol) fumarate) hydrogels. J Control Release. 2005;104:521–539.

    Article  PubMed  CAS  Google Scholar 

  30. Kasper FK, Young S, Tanahashi K, Barry MA, Tabata Y, Jansen JA, Mikos AG. Evaluation of bone regeneration by DNA release from composites of oligo(poly(ethylene glycol) fumarate) and cationized gelatin microspheres in a critical-sized calvarial defect. J Biomed Mater Res A. 2006;78:335–342.

    PubMed  Google Scholar 

  31. Kato N, Gehrke SH. Microporous, fast response cellulose ether hydrogel prepared by freeze-drying. Colloids Surf B Biointerfaces. 2004;38:191–196.

    Article  PubMed  CAS  Google Scholar 

  32. Knutsen G, Engebretsen L, Ludvigsen TC, Drogset JO, Grøntvedt T, Solheim E, Strand T, Roberts S, Isaksen V, Johansen O. Autologous chondrocyte implantation compared with microfracture in the knee: a randomized trial. J Bone Joint Surg Am. 2004;86:455–464.

    PubMed  Google Scholar 

  33. Kocher MS, Tucker R, Ganley TJ, Flynn JM. Management of osteochondritis dissecans of the knee: current concepts review. Am J Sports Med. 2006;34:1181–1191.

    Article  PubMed  Google Scholar 

  34. Kon E, Filardo G, Berruto M, Benazzo F, Zanon G, Della Villa S, Marcacci M. Articular cartilage treatment in high-level male soccer players: a prospective comparative study of arthroscopic second-generation autologous chondrocyte implantation versus microfracture. Am J Sports Med. 2011;39:2549–2557.

    Article  PubMed  Google Scholar 

  35. Kon E, Filardo G, Delcogliano M, Fini M, Salamanna F, Giavaresi G, Martin I, Marcacci M. Platelet autologous growth factors decrease the osteochondral regeneration capability of a collagen-hydroxyapatite scaffold in a sheep model. BMC Musculoskelet Disord. 2010;11:220.

    Article  PubMed  Google Scholar 

  36. Kon E, Gobbi A, Filardo G, Delcogliano M, Zaffagnini S, Marcacci M. Arthroscopic second-generation autologous chondrocyte implantation compared with microfracture for chondral lesions of the knee: prospective nonrandomized study at 5 years. Am J Sports Med. 2009;37:33–41.

    Article  PubMed  Google Scholar 

  37. Kon E, Mutini A, Arcangeli E, Delcogliano M, Filardo G, Nicoli Aldini N, Pressato D, Quarto R, Zaffagnini S, Marcacci M. Novel nanostructured scaffold for osteochondral regeneration: pilot study in horses. J Tissue Eng Regen Med. 2010;4:300–308.

    Article  PubMed  CAS  Google Scholar 

  38. Kreuz PC, Erggelet C, Steinwachs MR, Krause SJ, Lahm A, Niemeyer P, Ghanem N, Uhl M, Südkamp N. Is microfracture of chondral defects in the knee associated with different results in patients aged 40 years or younger? Arthroscopy. 2006;22:1180–1186.

    Article  PubMed  Google Scholar 

  39. Miura K, Ishibashi Y, Tsuda E, Sato H, Toh S. Results of arthroscopic fixation of osteochondritis dissecans lesion of the knee with cylindrical autogenous osteochondral plugs. Am J Sports Med. 2007;35:216–222.

    Article  PubMed  Google Scholar 

  40. Ochs BG, Müller-Horvat C, Albrecht D, Schewe B, Weise K, Aicher WK, Rolauffs B. Remodeling of articular cartilage and subchondral bone after bone grafting and matrix-associated autologous chondrocyte implantation for osteochondritis dissecans of the knee. Am J Sports Med. 2011;39:764–773.

    Article  PubMed  Google Scholar 

  41. Oshima Y, Harwood FL, Coutts RD, Kubo T, Amiel D. Variation of mesenchymal cells in polylactic acid scaffold in an osteochondral repair model. Tissue Eng Part C Methods. 2009;15:595–604.

    Article  PubMed  CAS  Google Scholar 

  42. Park H, Guo X, Temenoff JS, Tabata Y, Caplan AI, Kasper FK, Mikos AG. Effect of swelling ratio of injectable hydrogel composites on chondrogenic differentiation of encapsulated rabbit marrow mesenchymal stem cells in vitro. Biomacromolecules. 2009;10:541–546.

    Article  PubMed  CAS  Google Scholar 

  43. Park H, Temenoff JS, Holland TA, Tabata Y, Mikos AG. Delivery of TGF-beta1 and chondrocytes via injectable, biodegradable hydrogels for cartilage tissue engineering applications. Biomaterials. 2005;26:7095–7103.

    Article  PubMed  CAS  Google Scholar 

  44. Park H, Temenoff JS, Tabata Y, Caplan AI, Mikos AG. Injectable biodegradable hydrogel composites for rabbit marrow mesenchymal stem cell and growth factor delivery for cartilage tissue engineering. Biomaterials. 2007;28:3217–3227.

    Article  PubMed  CAS  Google Scholar 

  45. Park H, Temenoff JS, Tabata Y, Caplan AI, Raphael RM, Jansen JA, Mikos AG. Effect of dual growth factor delivery on chondrogenic differentiation of rabbit marrow mesenchymal stem cells encapsulated in injectable hydrogel composites. J Biomed Mater Res A. 2009;88:889–897.

    PubMed  Google Scholar 

  46. Polousky JD. Juvenile osteochondritis dissecans. Sports Med Arthrosc. 2011;19:56–63.

    Article  PubMed  Google Scholar 

  47. Saris DB, Vanlauwe J, Victor J, Haspl M, Bohnsack M, Fortems Y, Vandekerckhove B, Almqvist KF, Claes T, Handelberg F, Lagae K, van der Bauwhede J, Vandenneucker H, Yang KG, Jelic M, Verdonk R, Veulemans N, Bellemans J, Luyten FP. Characterized chondrocyte implantation results in better structural repair when treating symptomatic cartilage defects of the knee in a randomized controlled trial versus microfracture. Am J Sports Med. 2008;36:235–246.

    Article  PubMed  Google Scholar 

  48. Schagemann JC, Erggelet C, Chung HW, Lahm A, Kurz H, Mrosek EH. Cell-laden and cell-free biopolymer hydrogel for the treatment of osteochondral defects in a sheep model. Tissue Eng Part A. 2009;15:75-82.

    Article  PubMed  CAS  Google Scholar 

  49. Shin H, Quinten Ruhé P, Mikos AG, Jansen JA. In vivo bone and soft tissue response to injectable, biodegradable oligo(poly(ethylene glycol) fumarate) hydrogels. Biomaterials. 2003;24:3201–3211.

    Article  PubMed  CAS  Google Scholar 

  50. Shin H, Temenoff JS, Mikos AG. In vitro cytotoxicity of unsaturated oligo[poly(ethylene glycol) fumarate] macromers and their cross-linked hydrogels. Biomacromolecules. 2003;4:552–560.

    Article  PubMed  CAS  Google Scholar 

  51. Steadman JR, Briggs KK, Rodrigo JJ, Kocher MS, Gill TJ, Rodkey WG. Outcomes of microfracture for traumatic chondral defects of the knee: average 11-year follow-up. Arthroscopy. 2003;19:477–484.

    Article  PubMed  Google Scholar 

  52. Steinhagen J, Bruns J, Deuretzbacher G, Ruether W, Fuerst M, Niggemeyer O. Treatment of osteochondritis dissecans of the femoral condyle with autologous bone grafts and matrix-supported autologous chondrocytes. Int Orthop. 2010;34:819–825.

    Article  PubMed  Google Scholar 

  53. Stenhamre H, Nannmark U, Lindahl A, Gatenholm P, Brittberg M. Influence of pore size on the redifferentiation potential of human articular chondrocytes in poly(urethane urea) scaffolds. J Tissue Eng Regen Med. 2011;5:578–588.

    Article  PubMed  CAS  Google Scholar 

  54. Temenoff JS, Athanasiou KA, LeBaron RG, Mikos AG. Effect of poly(ethylene glycol) molecular weight on tensile and swelling properties of oligo(poly(ethylene glycol) fumarate) hydrogels for cartilage tissue engineering. J Biomed Mater Res. 2002;59:429–437.

    Article  PubMed  CAS  Google Scholar 

  55. Temenoff JS, Park H, Jabbari E, Conway DE, Sheffield TL, Ambrose CG, Mikos AG. Thermally cross-linked oligo(poly(ethylene glycol) fumarate) hydrogels support osteogenic differentiation of encapsulated marrow stromal cells in vitro. Biomacromolecules. 2004;5:5–10.

    Article  PubMed  CAS  Google Scholar 

  56. Temenoff JS, Park H, Jabbari E, Sheffield TL, LeBaron RG, Ambrose CG, Mikos AG. In vitro osteogenic differentiation of marrow stromal cells encapsulated in biodegradable hydrogels. J Biomed Mater Res A. 2004;70:235–244.

    Article  PubMed  Google Scholar 

  57. Temenoff JS, Steinbis ES, Mikos AG. Effect of drying history on swelling properties and cell attachment to oligo(poly(ethylene glycol) fumarate) hydrogels for guided tissue regeneration applications. J Biomater Sci Polym Ed. 2003;14:989–1004.

    Article  PubMed  CAS  Google Scholar 

  58. Timmer MD, Shin H, Horch RA, Ambrose CG, Mikos AG. In vitro cytotoxicity of injectable and biodegradable poly(propylene fumarate)-based networks: unreacted macromers, cross-linked networks, and degradation products. Biomacromolecules. 2003;4:1026–1033.

    Article  PubMed  CAS  Google Scholar 

  59. Trinh TQ, Harris JD, Flanigan DC. Surgical management of juvenile osteochondritis dissecans of the knee. Knee Surg Sports Traumatol Arthrosc. 2012 February 11 [Epub ahead of print].

  60. Wakitani S, Goto T, Pineda SJ, Young RG, Mansour JM, Caplan AI, Goldberg VM. Mesenchymal cell-based repair of large, full-thickness defects of articular cartilage. J Bone Joint Surg Am. 1994;76:579–592.

    PubMed  CAS  Google Scholar 

  61. Yang Q, Peng J, Lu SB, Guo QY, Zhao B, Zhang L, Wang AY, Xu WJ, Xia Q, Ma XL, Hu YC, Xu BS. Evaluation of an extracellular matrix-derived acellular biphasic scaffold/cell construct in the repair of a large articular high-load-bearing osteochondral defect in a canine model. Chin Med J (Engl). 2011;124:3930–3938.

    CAS  Google Scholar 

  62. Yen YM, Steadman JR. Microfracture for osteochondritis dissecans lesions. Oper Tech Sports Med. 2008;16:77–80.

    Article  Google Scholar 

  63. Yokota M, Yasuda K, Kitamura N, Arakaki K, Onodera S, Kurokawa T, Gong JP. Spontaneous hyaline cartilage regeneration can be induced in an osteochondral defect created in the femoral condyle using a novel double-network hydrogel. BMC Musculoskelet Disord. 2011;12:49.

    Article  PubMed  CAS  Google Scholar 

  64. Yoshizumi Y, Sugita T, Kawamata T, Ohnuma M, Maeda S. Cylindrical osteochondral graft for osteochondritis dissecans of the knee: a report of three cases. Am J Sports Med. 2002;30:441–445.

    PubMed  Google Scholar 

Download references

Acknowledgments

We thank Chin Tat Lim, MBBS, Zheng Yang, PhD, Yingnan Wu, MSc, and Awang Shukrimi, MBBS, for help with animal surgery, SEM, mechanical testing, histologic analysis, and write-up of the initial draft.

Author information

Authors and Affiliations

  1. Cartilage Repair Program, Therapeutic Tissue Engineering Laboratory, Department of Orthopaedic Surgery, National University Health System, National University of Singapore, 1E, Kent Ridge Road, Singapore, 119288, Singapore

    James H. Hui FRCS, MD

  2. Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore , Singapore

    Xiafei Ren PhD

  3. Department of Orthopaedic Surgery, National University Health System, National University Hospital, Singapore, Singapore

    Mohd Hassan Afizah MSc

  4. Division of Manufacturing, School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore, Singapore

    Kerm Sin Chian PhD

  5. Department of Chemical Engineering and Bioengineering, Rice University, Houston, TX, USA

    Antonios G. Mikos PhD

Authors
  1. James H. Hui FRCS, MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Xiafei Ren PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mohd Hassan Afizah MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kerm Sin Chian PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Antonios G. Mikos PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to James H. Hui FRCS, MD.

Additional information

One or more of the authors (JHH, XR), have received, during the study period, funding from Singapore National Medical Research Council (Grant Number NMRC 1142/2007).

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

Clinical Orthopaedics and Related Research neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA approval status, of any drug or device before clinical use.

Each author certifies that his or her institution approved the animal protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

This work was performed at the Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

About this article

Cite this article

Hui, J.H., Ren, X., Afizah, M.H. et al. Oligo[poly(ethylene glycol)fumarate] Hydrogel Enhances Osteochondral Repair in Porcine Femoral Condyle Defects. Clin Orthop Relat Res 471, 1174–1185 (2013). https://doi.org/10.1007/s11999-012-2487-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11999-012-2487-0

Keywords

Search

Navigation