International Orthopaedics

, Volume 42, Issue 7, pp 1755–1767 | Cite as

Effects of press-fit biphasic (collagen and HA/βTCP) scaffold with cell-based therapy on cartilage and subchondral bone repair knee defect in rabbits

  • Jacques HernigouEmail author
  • Pascale Vertongen
  • Esfandiar Chahidi
  • Theofylaktos Kyriakidis
  • Jean-Paul Dehoux
  • Magalie Crutzen
  • Sébastien Boutry
  • Lionel Larbanoix
  • Sarah Houben
  • Nathalie Gaspard
  • Dimitrios Koulalis
  • Joanne Rasschaert
Original Paper



Human spontaneous osteonecrosis of the knee (SPONK) is still challenging as the current treatments do not allow the production of hyaline cartilage tissue. The aim of the present study was to explore the therapeutic potential of cartilage regeneration using a new biphasic scaffold (type I collagen/hydroxyapatite) previously loaded or not with concentrated bone marrow cells.

Material and methods

Female rabbits were operated of one knee to create articular lesions of the trochlea (three holes of 4 × 4mm). The holes were left empty in the control group or were filled with the scaffold alone or the scaffold previously loaded with concentrated bone marrow cells. After two months, rabbits were sacrificed and the structure of the newly formed tissues were evaluated by macroscopic, MRI, and immunohistochemistry analyses.


Macroscopic and MRI evaluation of the knees did not show differences between the three groups (p > 0.05). However, histological analysis demonstrated that a higher O’Driscoll score was obtained in the two groups treated with the scaffold, as compared to the control group (p < 0.05). The number of cells in treated area was higher in scaffold groups compared to the control group (p < 0.05). There was no difference for intensity of collagen type II between the groups (p > 0.05) but subchondral bone repair was significantly thicker in scaffold-treated groups than in the control group (1 mm for the control group vs 2.1 and 2.6 mm for scaffold groups). Furthermore, we observed that scaffolds previously loaded with concentrated bone marrow were more reabsorbed (p < 0.05).


The use of a biphasic scaffold previously loaded with concentrated bone marrow significantly improves cartilage lesion healing.


Spontaneous osteonecrosis of the knee Cartilage repair Bone marrow cells Biphasic scaffold 



This work was supported by a research subvention of Novagenit Srl and a research grant of the “Société Royale Belge de Chirurgie Orthopédique et de Traumatologie” (SORBCOT).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All applicable international, national, and institutional guidelines for the care and use of animals were followed. All procedures performed in the study were in accordance with the ethical standards of the institution.

Ethics approval was granted by Université libre de Bruxelles (ULB) Animal Ethics Committee (618N June 2016) and Université catholique de Louvain (UCL) Animal Ethics Committee (2016/UCL/MD/014 August 2016).


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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  • Jacques Hernigou
    • 1
    • 2
    Email author
  • Pascale Vertongen
    • 2
  • Esfandiar Chahidi
    • 1
  • Theofylaktos Kyriakidis
    • 3
  • Jean-Paul Dehoux
    • 4
  • Magalie Crutzen
    • 4
  • Sébastien Boutry
    • 5
  • Lionel Larbanoix
    • 5
  • Sarah Houben
    • 6
  • Nathalie Gaspard
    • 2
  • Dimitrios Koulalis
    • 3
  • Joanne Rasschaert
    • 2
  1. 1.Department of Orthopaedic and Traumatology SurgeryEpiCURA HospitalHornuBelgium
  2. 2.Laboratory of Bone and Metabolic Biochemistry, Faculty of MedicineUniversité libre de BruxellesBrusselsBelgium
  3. 3.Department of Orthopaedic and Traumatology Surgery – Erasme HospitalUniversité libre de BruxellesBrusselsBelgium
  4. 4.Institute of Experimental and Clinical Research (IREC), Laboratory of Experimental Surgery and Transplantation (CHEX)Université catholique de LouvainBrusselsBelgium
  5. 5.Center for Microscopy and Molecular Imaging (CMMI)Université de Mons (UMONS)CharleroiBelgium
  6. 6.Laboratory of Histology, Neuroanatomy and Neuropathology, Faculty of MedicineUniversité libre de BruxellesBrusselsBelgium

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