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One-step osteochondral repair with cartilage fragments in a composite scaffold

  • Experimental Study
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study proposes a single-step therapeutic approach for osteochondral defects using autologous cartilage fragments loaded onto a scaffold composed of a hyaluronic acid (HA) derivative, human fibrin glue (FG) and autologous platelet-rich-plasma (PRP), in a rabbit model. The aim is to demonstrate the in vitro outgrowth of chondrocytes from cartilage fragments and the in vivo formation of a functional repair tissue.

Methods

In vitro: minced articular cartilage was loaded onto two different types of scaffold (paste or membrane) according to two different HA preparations (injectable HA-derivative or HA-derivative felt). In vivo: trochlear osteochondral defects were created in 50 adult rabbits, which were then assigned to 5 different treatment groups: cartilage fragments loaded onto membrane scaffolds with FG (Group 1) or without FG (Group 2); membrane scaffolds alone with FG (Group 3) or without FG (Group 4); empty defects (Group 5). Membrane scaffolds were used “in vivo” for simpler preparation and better adhesive properties. Repair processes were evaluated histologically and by immunohistochemistry at 1, 3, and 6 months.

Results

An in vitro time-dependent cell outgrowth from cartilage fragments was observed with both types of scaffolds. At 6 months, in vivo, cartilage fragment-loaded scaffolds induced significantly better repair tissue than the scaffold alone using histological scoring. Repair in Group 2 was superior to that in any of the control groups (p < 0.05).

Conclusion

Autologous cartilage fragments loaded onto an HA felt/FG/PRP-scaffold provided an efficient cell source, and allowed for an improvement of the repair process of ostechondral defects in a rabbit model. Human FG, however, hampered the rabbit healing process. These results may have clinical relevance as they show the potential of a novel one-stage repair technique for osteochondral defects.

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Acknowledgments

This work was supported by “DJ ESSKA Ortho Grant 2006” and “CRT (Cassa di Risparmio di Torino)–Alfieri project” (independent research fund). Authors are grateful to F.a.b. (Fidia advanced biopolymers) for donation of Hyaff-11 membranes and to Sergio D’Antico MD and Paola Manzini MD for the help in the preparation of the rabbit PRP. We would also like to thank Radhika Srinivasan, PhD, for editing of the manuscript.

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Authors and Affiliations

  1. Department of Orthopaedics and Traumatology, University of Torino, Torino, Italy

    A. Marmotti, M. Bruzzone, D. E. Bonasia, F. Castoldi, R. Rossi & A. Maiello

  2. Department of Animal Pathology, Surgery Section, University of Torino, Torino, Italy

    L. Piras

  3. Molecular Biotechnology Center, University of Torino, Torino, Italy

    C. Realmuto

  4. Department of Sport, Nutrition and Health Sciences, University of Milan, Milan, Italy

    G. M. Peretti

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  1. A. Marmotti
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  2. M. Bruzzone
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Correspondence to A. Marmotti.

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Marmotti, A., Bruzzone, M., Bonasia, D.E. et al. One-step osteochondral repair with cartilage fragments in a composite scaffold. Knee Surg Sports Traumatol Arthrosc 20, 2590–2601 (2012). https://doi.org/10.1007/s00167-012-1920-y

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  • DOI: https://doi.org/10.1007/s00167-012-1920-y

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