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Yang F, Li Y, Wang L, Che H, Zhang X, Jahr H, Wang L, Jiang D, Huang H, Wang J. Full-thickness osteochondral defect repair using a biodegradable bilayered scaffold of porous zinc and chondroitin sulfate hydrogel. Bioact Mater 2024; 32:400-414. [PMID: 37885916 PMCID: PMC10598503 DOI: 10.1016/j.bioactmat.2023.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 09/26/2023] [Accepted: 10/15/2023] [Indexed: 10/28/2023] Open
Abstract
The regeneration of osteochondral tissue necessitates the re-establishment of a gradient owing to the unique characteristics and healing potential of the chondral and osseous phases. As the self-healing capacity of hyaline cartilage is limited, timely mechanical support during neo-cartilage formation is crucial to achieving optimal repair efficacy. In this study, we devised a biodegradable bilayered scaffold, comprising chondroitin sulfate (CS) hydrogel to regenerate chondral tissue and a porous pure zinc (Zn) scaffold for regeneration of the underlying bone as mechanical support for the cartilage layer. The photocured CS hydrogel possessed a compressive strength of 82 kPa, while the porous pure Zn scaffold exhibited a yield strength of 11 MPa and a stiffness of 0.8 GPa. Such mechanical properties are similar to values reported for cancellous bone. In vitro biological experiments demonstrated that the bilayered scaffold displayed favorable cytocompatibility and promoted chondrogenic and osteogenic differentiation of bone marrow stem cells. Upon implantation, the scaffold facilitated the simultaneous regeneration of bone and cartilage tissue in a porcine model, resulting in (i) a smoother cartilage surface, (ii) more hyaline-like cartilage, and (iii) a superior integration into the adjacent host tissue. Our bilayered scaffold exhibits significant potential for clinical application in osteochondral regeneration.
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Affiliation(s)
- Fan Yang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, Beijing, China
| | - Yageng Li
- Beijing Advanced Innovation Center for Materials Genome Engineering, State Key Laboratory for Advanced Metals and Materials, School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing, China
| | - Lei Wang
- Beijing Advanced Innovation Center for Materials Genome Engineering, State Key Laboratory for Advanced Metals and Materials, School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing, China
| | - Haodong Che
- Beijing Advanced Innovation Center for Materials Genome Engineering, State Key Laboratory for Advanced Metals and Materials, School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing, China
| | - Xin Zhang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, Beijing, China
| | - Holger Jahr
- Institute of Anatomy and Cell Biology, University Hospital RWTH Aachen, Aachen, 52074, Germany
- Institute of Structural Mechanics and Lightweight Design, RWTH Aachen University, 52062, Aachen, Germany
| | - Luning Wang
- Beijing Advanced Innovation Center for Materials Genome Engineering, State Key Laboratory for Advanced Metals and Materials, School of Materials Science and Engineering, University of Science and Technology Beijing, Beijing, China
| | - Dong Jiang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, Beijing, China
| | - Hongjie Huang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, Beijing, China
| | - Jianquan Wang
- Department of Sports Medicine, Peking University Third Hospital, Institute of Sports Medicine of Peking University, Beijing Key Laboratory of Sports Injuries, Engineering Research Center of Sports Trauma Treatment Technology and Devices, Ministry of Education, Beijing, China
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2
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Banihashemian A, Benisi SZ, Hosseinzadeh S, Shojaei S. Biomimetic biphasic scaffolds in osteochondral tissue engineering: Their composition, structure and consequences. Acta Histochem 2023; 125:152023. [PMID: 36940532 DOI: 10.1016/j.acthis.2023.152023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 03/23/2023]
Abstract
Approaches to the design and construction of biomimetic scaffolds for osteochondral tissue, show increasing advances. Considering the limitations of this tissue in terms of repair and regeneration, there is a need to develop appropriately designed scaffolds. A combination of biodegradable polymers especially natural polymers and bioactive ceramics, shows promise in this field. Due to the complicated architecture of this tissue, biphasic and multiphasic scaffolds containing two or more different layers, could mimic the physiology and function of this tissue with a higher degree of similarity. The purpose of this review article is to discuss the approaches focused on the application of biphasic scaffolds for osteochondral tissue engineering, common methods of combining layers and the ultimate consequences of their use in patients were discussed.
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Affiliation(s)
- Abdolvahab Banihashemian
- Advanced Medical Sciences and Technologies Department, Faculty of Biomedical Engineering, Central Tehran Branch Islamic Azad University, Tehran, Iran.
| | - Soheila Zamanlui Benisi
- Stem Cell Research Center, Tissue Engineering and Regenerative Medicine Institute, Tehran Central Branch, Islamic Azad University, Tehran, Iran
| | - Simzar Hosseinzadeh
- Medical Nanotechnology and Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Shahrokh Shojaei
- Islamic Azad University Central Tehran Branch, Department of Biomedical Engineering, Tehran, Iran
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3
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Dewey MJ, Collins AJ, Tiffany A, Barnhouse VR, Lu C, Kolliopoulos V, Mutreja I, Hickok NJ, Harley BAC. Evaluation of bacterial attachment on mineralized collagen scaffolds and addition of manuka honey to increase mesenchymal stem cell osteogenesis. Biomaterials 2023; 294:122015. [PMID: 36701999 PMCID: PMC9928779 DOI: 10.1016/j.biomaterials.2023.122015] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 01/06/2023] [Accepted: 01/14/2023] [Indexed: 01/21/2023]
Abstract
The design of biomaterials to regenerate bone is likely to increasingly require modifications that reduce bacterial attachment and biofilm formation as infection during wound regeneration can significantly impede tissue repair and typically requires surgical intervention to restart the healing process. Further, much research on infection prevention in bone biomaterials has focused on modeling of non-resorbable metal alloy materials, whereas an expanding direction of bone regeneration has focused on development of bioresorbable materials. This represents a need for the prevention and understanding of infection in resorbable biomaterials. Here, we investigate the ability of a mineralized collagen biomaterial to natively resist infection and examine how the addition of manuka honey, previously identified as an antimicrobial agent, affects gram positive and negative bacterial colonization and mesenchymal stem cell osteogenesis and vasculature formation. We incorporate manuka honey into these scaffolds via either direct fabrication into the scaffold microarchitecture or via soaking the scaffold in a solution of manuka honey after fabrication. Direct incorporation results in a change in the surface characteristics and porosity of mineralized collagen scaffolds. Soaking scaffolds in honey concentrations higher than 10% had significant negative effects on mesenchymal stem cell metabolic activity. Soaking or incorporating 5% honey had no impact on endothelial cell tube formation. Although solutions of 5% honey reduced metabolic activity of mesenchymal stem cells, MSC-seeded scaffolds displayed increased calcium and phosphorous mineral formation, osteoprotegerin release, and alkaline phosphatase activity. Bacteria cultured on mineralized collagen scaffolds demonstrated surfaces covered in bacteria and no method of preventing infection, and using 10 times the minimal inhibitory concentration of antibiotics did not completely kill bacteria within the mineralized collagen scaffolds, indicating bioresorbable scaffold materials may act to shield bacteria from antibiotics. The addition of 5% manuka honey to scaffolds was not sufficient to prevent P. aeruginosa attachment or consistently reduce the activity of methicillin resistant staphylococcus aureus, and concentrations above 7% manuka honey are likely necessary to impact MRSA. Together, our results suggest bioresorbable scaffolds may create an environment conducive to bacterial growth, and potential trade-offs exist for the incorporation of low levels of honey in scaffolds to increase osteogenic potential of osteoprogenitors while high-levels of honey may be sufficient to reduce gram positive or negative bacteria activity but at the cost of reduced osteogenesis.
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Affiliation(s)
- Marley J Dewey
- Dept. of Materials Science and Engineering, University of Illinois Urbana-Champaign, Urbana, IL, 61801, USA
| | - Alan J Collins
- Carl R. Woese Institute for Genomic Biology, University of Illinois Urbana-Champaign, Urbana, IL, 61801, USA
| | - Aleczandria Tiffany
- Dept. of Chemical and Biomolecular Engineering, University of Illinois Urbana-Champaign, Urbana, IL, 61801, USA
| | - Victoria R Barnhouse
- Dept. of Bioengineering, University of Illinois Urbana-Champaign, Urbana, IL, 61801, USA
| | - Crislyn Lu
- School of Chemical Sciences, University of Illinois Urbana-Champaign, Urbana, IL, 61801, USA
| | - Vasiliki Kolliopoulos
- Dept. of Bioengineering, University of Illinois Urbana-Champaign, Urbana, IL, 61801, USA
| | - Isha Mutreja
- Department of Restorative Science, Minnesota Dental Research Center for Biomaterials and Biomechanics, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Noreen J Hickok
- Department of Orthopaedic Surgery, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Brendan A C Harley
- Dept. of Materials Science and Engineering, University of Illinois Urbana-Champaign, Urbana, IL, 61801, USA; Carl R. Woese Institute for Genomic Biology, University of Illinois Urbana-Champaign, Urbana, IL, 61801, USA; Dept. of Chemical and Biomolecular Engineering, University of Illinois Urbana-Champaign, Urbana, IL, 61801, USA; Dept. of Bioengineering, University of Illinois Urbana-Champaign, Urbana, IL, 61801, USA; Cancer Center at Illinois, University of Illinois Urbana-Champaign, Urbana, IL, 61801, USA.
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Promoting endogenous articular cartilage regeneration using extracellular matrix scaffolds. Mater Today Bio 2022; 16:100343. [PMID: 35865410 PMCID: PMC9294195 DOI: 10.1016/j.mtbio.2022.100343] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 06/23/2022] [Accepted: 06/25/2022] [Indexed: 12/13/2022] Open
Abstract
Articular cartilage defects fail to heal spontaneously, typically progressing to osteoarthritis. Bone marrow stimulation techniques such as microfracture (MFX) are the current surgical standard of care; however MFX typically produces an inferior fibro-cartilaginous tissue which provides only temporary symptomatic relief. Here we implanted solubilised articular cartilage extracellular matrix (ECM) derived scaffolds into critically sized chondral defects in goats, securely anchoring these implants to the joint surface using a 3D-printed fixation device that overcame the need for sutures or glues. In vitro these ECM scaffolds were found to be inherently chondro-inductive, while in vivo they promoted superior articular cartilage regeneration compared to microfracture. In an attempt to further improve the quality of repair, we loaded these scaffolds with a known chemotactic factor, transforming growth factor (TGF)-β3. In vivo such TGF-β3 loaded scaffolds promoted superior articular cartilage regeneration. This study demonstrates that ECM derived biomaterials, either alone and particularly when combined with exogenous growth factors, can successfully treat articular cartilage defects in a clinically relevant large animal model.
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Spatial patterning of phenotypically distinct microtissues to engineer osteochondral grafts for biological joint resurfacing. Biomaterials 2022; 289:121750. [DOI: 10.1016/j.biomaterials.2022.121750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/11/2022] [Accepted: 08/16/2022] [Indexed: 02/04/2023]
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Rahman G, Frazier TP, Gimble JM, Mohiuddin OA. The Emerging Use of ASC/Scaffold Composites for the Regeneration of Osteochondral Defects. Front Bioeng Biotechnol 2022; 10:893992. [PMID: 35845419 PMCID: PMC9280640 DOI: 10.3389/fbioe.2022.893992] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Articular cartilage is composed of chondrocytes surrounded by a porous permeable extracellular matrix. It has a limited spontaneous healing capability post-injury which, if left untreated, can result in severe osteochondral disease. Currently, osteochondral (OC) defects are treated by bone marrow stimulation, artificial joint replacement, or transplantation of bone, cartilage, and periosteum, while autologous osteochondral transplantation is also an option; it carries the risk of donor site damage and is limited only to the treatment of small defects. Allografts may be used for larger defects; however, they have the potential to elicit an immune response. A possible alternative solution to treat osteochondral diseases involves the use of stromal/stem cells. Human adipose-derived stromal/stem cells (ASCs) can differentiate into cartilage and bone cells. The ASC can be combined with both natural and synthetic scaffolds to support cell delivery, growth, proliferation, migration, and differentiation. Combinations of both types of scaffolds along with ASCs and/or growth factors have shown promising results for the treatment of OC defects based on in vitro and in vivo experiments. Indeed, these findings have translated to several active clinical trials testing the use of ASC-scaffold composites on human subjects. The current review critically examines the literature describing ASC-scaffold composites as a potential alternative to conventional therapies for OC tissue regeneration.
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Affiliation(s)
- Gohar Rahman
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | | | | | - Omair A. Mohiuddin
- Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
- *Correspondence: Omair A. Mohiuddin,
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Browe DC, Díaz-Payno PJ, Freeman FE, Schipani R, Burdis R, Ahern DP, Nulty JM, Guler S, Randall LD, Buckley CT, Brama PA, Kelly DJ. Bilayered extracellular matrix derived scaffolds with anisotropic pore architecture guide tissue organization during osteochondral defect repair. Acta Biomater 2022; 143:266-281. [PMID: 35278686 DOI: 10.1016/j.actbio.2022.03.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 12/15/2022]
Abstract
While some clinical advances in cartilage repair have occurred, osteochondral (OC) defect repair remains a significant challenge, with current scaffold-based approaches failing to recapitulate the complex, hierarchical structure of native articular cartilage (AC). To address this need, we fabricated bilayered extracellular matrix (ECM)-derived scaffolds with aligned pore architectures. By modifying the freeze-drying kinetics and controlling the direction of heat transfer during freezing, it was possible to produce anisotropic scaffolds with larger pores which supported homogenous cellular infiltration and improved sulfated glycosaminoglycan deposition. Neo-tissue organization in vitro could also be controlled by altering scaffold pore architecture, with collagen fibres aligning parallel to the long-axis of the pores within scaffolds containing aligned pore networks. Furthermore, we used in vitro and in vivo assays to demonstrate that AC and bone ECM derived scaffolds could preferentially direct the differentiation of mesenchymal stromal cells (MSCs) towards either a chondrogenic or osteogenic lineage respectively, enabling the development of bilayered ECM scaffolds capable of spatially supporting unique tissue phenotypes. Finally, we implanted these scaffolds into a large animal model of OC defect repair. After 6 months in vivo, scaffold implantation was found to improve cartilage matrix deposition, with collagen fibres preferentially aligning parallel to the long axis of the scaffold pores, resulting in a repair tissue that structurally and compositionally was more hyaline-like in nature. These results demonstrate how scaffold architecture and composition can be spatially modulated to direct the regeneration of complex interfaces such as the osteochondral unit, enabling their use as cell-free, off-the-shelf implants for joint regeneration. STATEMENT OF SIGNIFICANCE: The architecture of the extracellular matrix, while integral to tissue function, is often neglected in the design and evaluation of regenerative biomaterials. In this study we developed a bilayered scaffold for osteochondral defect repair consisting of tissue-specific extracellular matrix (ECM)-derived biomaterials to spatially direct stem/progenitor cell differentiation, with a tailored pore microarchitecture to promote the development of a repair tissue that recapitulates the hierarchical structure of native AC. The use of this bilayered scaffold resulted in improved tissue repair outcomes in a large animal model, specifically the ability to guide neo-tissue organization and therefore recapitulate key aspects of the zonal structure of native articular cartilage. These bilayer scaffolds have the potential to become a new therapeutic option for osteochondral defect repair.
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8
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Small Ruminant Models for Articular Cartilage Regeneration by Scaffold-Based Tissue Engineering. Stem Cells Int 2021; 2021:5590479. [PMID: 34912460 PMCID: PMC8668357 DOI: 10.1155/2021/5590479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 10/10/2021] [Accepted: 11/08/2021] [Indexed: 11/29/2022] Open
Abstract
Animal models play an important role in preclinical studies, especially in tissue engineering scaffolds for cartilage repair, which require large animal models to verify the safety and effectiveness for clinical use. The small ruminant models are most widely used in this field than other large animals because they are cost-effective, easy to raise, not to mention the fact that the aforementioned animal presents similar anatomical features to that of humans. This review discusses the experimental study of tissue engineering scaffolds for knee articular cartilage regeneration in small ruminant models. Firstly, the selection of these scaffold materials and the preparation process in vitro that have been already used in vivo are briefly reviewed. Moreover, the major factors influencing the rational design and the implementation as well as advantages and limitations of small ruminants are also demonstrated. As regards methodology, this paper applies principles and methods followed by most researchers in the process of experimental design and operation of this kind. By summarizing and comparing different therapeutic concepts, this paper offers suggestions aiming to increase the effectiveness of preclinical research using small ruminant models and improve the process of developing corresponding therapies.
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Wei W, Dai H. Articular cartilage and osteochondral tissue engineering techniques: Recent advances and challenges. Bioact Mater 2021; 6:4830-4855. [PMID: 34136726 PMCID: PMC8175243 DOI: 10.1016/j.bioactmat.2021.05.011] [Citation(s) in RCA: 108] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/20/2021] [Accepted: 05/11/2021] [Indexed: 12/18/2022] Open
Abstract
In spite of the considerable achievements in the field of regenerative medicine in the past several decades, osteochondral defect regeneration remains a challenging issue among diseases in the musculoskeletal system because of the spatial complexity of osteochondral units in composition, structure and functions. In order to repair the hierarchical tissue involving different layers of articular cartilage, cartilage-bone interface and subchondral bone, traditional clinical treatments including palliative and reparative methods have showed certain improvement in pain relief and defect filling. It is the development of tissue engineering that has provided more promising results in regenerating neo-tissues with comparable compositional, structural and functional characteristics to the native osteochondral tissues. Here in this review, some basic knowledge of the osteochondral units including the anatomical structure and composition, the defect classification and clinical treatments will be first introduced. Then we will highlight the recent progress in osteochondral tissue engineering from perspectives of scaffold design, cell encapsulation and signaling factor incorporation including bioreactor application. Clinical products for osteochondral defect repair will be analyzed and summarized later. Moreover, we will discuss the current obstacles and future directions to regenerate the damaged osteochondral tissues.
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Affiliation(s)
- Wenying Wei
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Biomedical Materials and Engineering Research Center of Hubei Province, Wuhan University of Technology, Wuhan, 430070, China
- International School of Materials Science and Engineering, Wuhan University of Technology, Wuhan, 430070, China
| | - Honglian Dai
- State Key Laboratory of Advanced Technology for Materials Synthesis and Processing, Biomedical Materials and Engineering Research Center of Hubei Province, Wuhan University of Technology, Wuhan, 430070, China
- Foshan Xianhu Laboratory of the Advanced Energy Science and Technology Guangdong Laboratory, Xianhu Hydrogen Valley, Foshan, 528200, China
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Kresakova L, Danko J, Vdoviakova K, Medvecky L, Zert Z, Petrovova E, Varga M, Spakovska T, Pribula J, Gasparek M, Giretova M, Stulajterova R, Kolvek F, Andrejcakova Z, Simaiova V, Kadasi M, Vrabec V, Toth T, Hura V. In Vivo Study of Osteochondral Defect Regeneration Using Innovative Composite Calcium Phosphate Biocement in a Sheep Model. MATERIALS (BASEL, SWITZERLAND) 2021; 14:4471. [PMID: 34442993 PMCID: PMC8398687 DOI: 10.3390/ma14164471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/31/2021] [Accepted: 08/04/2021] [Indexed: 11/17/2022]
Abstract
This study aimed to clarify the therapeutic effect and regenerative potential of the novel, amino acids-enriched acellular biocement (CAL) based on calcium phosphate on osteochondral defects in sheep. Eighteen sheep were divided into three groups, the treated group (osteochondral defects filled with a CAL biomaterial), the treated group with a biocement without amino acids (C cement), and the untreated group (spontaneous healing). Cartilages of all three groups were compared with natural cartilage (negative control). After six months, sheep were evaluated by gross appearance, histological staining, immunohistochemical staining, histological scores, X-ray, micro-CT, and MRI. Treatment of osteochondral defects by CAL resulted in efficient articular cartilage regeneration, with a predominant structural and histological characteristic of hyaline cartilage, contrary to fibrocartilage, fibrous tissue or disordered mixed tissue on untreated defect (p < 0.001, modified O'Driscoll score). MRI results of treated defects showed well-integrated and regenerated cartilage with similar signal intensity, regularity of the articular surface, and cartilage thickness with respect to adjacent native cartilage. We have demonstrated that the use of new biocement represents an effective solution for the successful treatment of osteochondral defects in a sheep animal model, can induce an endogenous regeneration of cartilage in situ, and provides several benefits for the design of future therapies supporting osteochondral defect healing.
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Affiliation(s)
- Lenka Kresakova
- Department of Morphological Disciplines, University of Veterinary Medicine and Pharmacy in Kosice, Komenskeho 73, 041 81 Kosice, Slovakia; (J.D.); (K.V.); (E.P.); (V.S.)
| | - Jan Danko
- Department of Morphological Disciplines, University of Veterinary Medicine and Pharmacy in Kosice, Komenskeho 73, 041 81 Kosice, Slovakia; (J.D.); (K.V.); (E.P.); (V.S.)
| | - Katarina Vdoviakova
- Department of Morphological Disciplines, University of Veterinary Medicine and Pharmacy in Kosice, Komenskeho 73, 041 81 Kosice, Slovakia; (J.D.); (K.V.); (E.P.); (V.S.)
| | - Lubomir Medvecky
- Division of Functional and Hybrid Systems, Institute of Materials Research of SAS, Watsonova 47, 040 01 Kosice, Slovakia; (L.M.); (M.G.); (R.S.)
| | - Zdenek Zert
- Clinic of Horses, University of Veterinary Medicine and Pharmacy in Kosice, Komenskeho 73, 041 81 Kosice, Slovakia; (Z.Z.); (F.K.); (V.H.)
| | - Eva Petrovova
- Department of Morphological Disciplines, University of Veterinary Medicine and Pharmacy in Kosice, Komenskeho 73, 041 81 Kosice, Slovakia; (J.D.); (K.V.); (E.P.); (V.S.)
| | - Maros Varga
- Hospital AGEL Kosice-Saca, Lucna 57, 040 15 Kosice-Saca, Slovakia; (M.V.); (T.S.); (J.P.)
| | - Tatiana Spakovska
- Hospital AGEL Kosice-Saca, Lucna 57, 040 15 Kosice-Saca, Slovakia; (M.V.); (T.S.); (J.P.)
| | - Jozef Pribula
- Hospital AGEL Kosice-Saca, Lucna 57, 040 15 Kosice-Saca, Slovakia; (M.V.); (T.S.); (J.P.)
| | - Miroslav Gasparek
- Department of Engineering Science, University of Oxford, Parks Road, Oxford OX1 3PJ, UK;
| | - Maria Giretova
- Division of Functional and Hybrid Systems, Institute of Materials Research of SAS, Watsonova 47, 040 01 Kosice, Slovakia; (L.M.); (M.G.); (R.S.)
| | - Radoslava Stulajterova
- Division of Functional and Hybrid Systems, Institute of Materials Research of SAS, Watsonova 47, 040 01 Kosice, Slovakia; (L.M.); (M.G.); (R.S.)
| | - Filip Kolvek
- Clinic of Horses, University of Veterinary Medicine and Pharmacy in Kosice, Komenskeho 73, 041 81 Kosice, Slovakia; (Z.Z.); (F.K.); (V.H.)
| | - Zuzana Andrejcakova
- Department of Biology and Physiology, University of Veterinary Medicine and Pharmacy in Kosice, Komenskeho 73, 041 81 Kosice, Slovakia;
| | - Veronika Simaiova
- Department of Morphological Disciplines, University of Veterinary Medicine and Pharmacy in Kosice, Komenskeho 73, 041 81 Kosice, Slovakia; (J.D.); (K.V.); (E.P.); (V.S.)
| | - Marian Kadasi
- Clinic of Ruminants, University of Veterinary Medicine and Pharmacy in Kosice, Komenskeho 73, 041 81 Kosice, Slovakia;
| | - Vladimir Vrabec
- Clinic of Birds, Exotic and Free Living Animals, University of Veterinary Medicine and Pharmacy in Kosice, Komenskeho 73, 041 81 Kosice, Slovakia;
| | - Teodor Toth
- Department of Biomedical Engineering and Measurement, Faculty of Mechanical Engineering, Technical University of Kosice, Letna 9, 042 00 Kosice, Slovakia;
| | - Vladimir Hura
- Clinic of Horses, University of Veterinary Medicine and Pharmacy in Kosice, Komenskeho 73, 041 81 Kosice, Slovakia; (Z.Z.); (F.K.); (V.H.)
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Dewey MJ, Harley BAC. Biomaterial design strategies to address obstacles in craniomaxillofacial bone repair. RSC Adv 2021; 11:17809-17827. [PMID: 34540206 PMCID: PMC8443006 DOI: 10.1039/d1ra02557k] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/10/2021] [Indexed: 12/18/2022] Open
Abstract
Biomaterial design to repair craniomaxillofacial defects has largely focused on promoting bone regeneration, while there are many additional factors that influence this process. The bone microenvironment is complex, with various mechanical property differences between cortical and cancellous bone, a unique porous architecture, and multiple cell types that must maintain homeostasis. This complex environment includes a vascular architecture to deliver cells and nutrients, osteoblasts which form new bone, osteoclasts which resorb excess bone, and upon injury, inflammatory cells and bacteria which can lead to failure to repair. To create biomaterials able to regenerate these large missing portions of bone on par with autograft materials, design of these materials must include methods to overcome multiple obstacles to effective, efficient bone regeneration. These obstacles include infection and biofilm formation on the biomaterial surface, fibrous tissue formation resulting from ill-fitting implants or persistent inflammation, non-bone tissue formation such as cartilage from improper biomaterial signals to cells, and voids in bone infill or lengthy implant degradation times. Novel biomaterial designs may provide approaches to effectively induce osteogenesis and new bone formation, include design motifs that facilitate surgical handling, intraoperative modification and promote conformal fitting within complex defect geometries, induce a pro-healing immune response, and prevent bacterial infection. In this review, we discuss the bone injury microenvironment and methods of biomaterial design to overcome these obstacles, which if unaddressed, may result in failure of the implant to regenerate host bone.
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Affiliation(s)
- Marley J. Dewey
- Dept of Materials Science and Engineering, University of Illinois at Urbana-ChampaignUrbanaIL 61801USA
| | - Brendan A. C. Harley
- Dept of Materials Science and Engineering, University of Illinois at Urbana-ChampaignUrbanaIL 61801USA
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-ChampaignUrbanaIL 61801USA
- Dept of Chemical and Biomolecular Engineering, University of Illinois at Urbana-Champaign, 110 Roger Adams Laboratory600 S. Mathews AveUrbanaIL 61801USA+1-217-333-5052+1-217-244-7112
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Bilayer Scaffolds for Interface Tissue Engineering and Regenerative Medicine: A Systematic Reviews. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2021; 1347:83-113. [PMID: 33931833 DOI: 10.1007/5584_2021_637] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE This systematic review focus on the application of bilayer scaffolds as an engaging structure for the engineering of multilayered tissues, including vascular and osteochondral tissues, skin, nerve, and urinary bladder. This article provides a concise literature review of different types of bilayer scaffolds to understand their efficacy in targeted tissue engineering. METHODS To this aim, electronic search in the English language was performed in PMC, NBCI, and PubMed from April 2008 to December 2019 based on the PRISMA guidelines. Animal studies, including the "bilayer scaffold" and at least one of the following items were examined: osteochondral tissue, bone, skin, neural tissue, urinary bladder, vascular system. The articles which didn't include "tissue engineering" and just in vitro studies were excluded. RESULTS Totally, 600 articles were evaluated; related articles were 145, and 35 full-text English articles met all the criteria. Fifteen articles in soft tissue engineering and twenty items in hard tissue engineering were the results of this exploration. Based on selected papers, it was revealed that the bilayer scaffolds were used in the regeneration of the multilayered tissues. The highest multilayered tissue regeneration has been achieved when bilayer scaffolds were used with mesenchymal stem cells and differentiation medium before implanting. Among the studies being reported in this review, bone marrow mesenchymal stem cells are the most studied mesenchymal stem cells. Among different kinds of multilayer tissue, the bilayer scaffold has been most used in osteochondral tissue engineering in which collagen and PLGA have been the most frequently used biomaterials. After osteochondral tissue engineering, bilayer scaffolds were widely used in skin tissue engineering. CONCLUSION The current review aimed to manifest the researcher and surgeons to use a more sophisticated bilayer scaffold in combinations of appropriate stem cells, and different can improve multilayer tissue regeneration. This systematic review can pave a way to design a suitable bilayer scaffold for a specific target tissue and conjunction with proper stem cells.
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Dorcemus DL, Kim HS, Nukavarapu SP. Gradient scaffold with spatial growth factor profile for osteochondral interface engineering. Biomed Mater 2020; 16. [PMID: 33291092 DOI: 10.1088/1748-605x/abd1ba] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 12/08/2020] [Indexed: 11/11/2022]
Abstract
Osteochondral (OC) matrix design poses a significant engineering challenge due to the complexity involved with bone-cartilage interfaces. To better facilitate the regeneration of OC tissue, we developed and evaluated a biodegradable matrix with uniquely arranged bone and cartilage supporting phases: a poly(lactic-co-glycolic) acid (PLGA) template structure with a porosity gradient along its longitudinal axis uniquely integrated with hyaluronic acid hydrogel. Micro-CT scanning and imaging confirmed the formation of an inverse gradient matrix. Hydroxyapatite was added to the PLGA template which was then plasma-treated to increase hydrophilicity and growth factor affinity. An osteogenic growth factor (bone morphogenetic protein 2; BMP-2) was loaded onto the template scaffold via adsorption, while a chondrogenic growth factor (transforming growth factor beta 1; TGF-β1) was incorporated into the hydrogel phase. Confocal microscopy of the growth factor loaded matrix confirmed the spatial distribution of the two growth factors, with chondrogenic factor confined to the cartilaginous portion and osteogenic factor present throughout the scaffold. We observed spatial differentiation of human mesenchymal stem cells (hMSCs) into cartilage and bone cells in the scaffolds in vitro: cartilaginous regions were marked by increased glycosaminoglycan production, and osteogenesis was seen throughout the graft by alizarin red staining. In a dose-dependent study of BMP-2, hMSC pellet cultures with TGF-β1 and BMP-2 showed synergistic effects on chondrogenesis. These results indicate that development of an inverse gradient matrix can spatially distribute two different growth factors to facilitate chondrogenesis and osteogenesis along different portions of a scaffold, which are key steps needed for formation of an osteochondral interface.
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Affiliation(s)
- Deborah Leonie Dorcemus
- Department of Biomedical Engineering, University of Connecticut, 260 Glenbrook Road, Unit 3247, Storrs, Connecticut, 06269, UNITED STATES
| | - Hyun Sung Kim
- Department of Biomedical Engineering, University of Connecticut, 260 Glenbrook Road, Unit 3247, Storrs, Connecticut, 06269, UNITED STATES
| | - Syam Prasad Nukavarapu
- Department of Biomedical Engineering, University of Connecticut, 260 Glenbrook Road, Unit 3247, Storrs, Connecticut, 06269, UNITED STATES
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Barajaa MA, Nair LS, Laurencin CT. Bioinspired Scaffold Designs for Regenerating Musculoskeletal Tissue Interfaces. REGENERATIVE ENGINEERING AND TRANSLATIONAL MEDICINE 2020; 6:451-483. [PMID: 33344758 PMCID: PMC7747886 DOI: 10.1007/s40883-019-00132-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 08/14/2019] [Accepted: 09/13/2019] [Indexed: 12/17/2022]
Abstract
The musculoskeletal system works at a very advanced level of synchrony, where all the physiological movements of the body are systematically performed through well-organized actions of bone in conjunction with all the other musculoskeletal soft tissues, such as ligaments, tendons, muscles, and cartilage through tissue-tissue interfaces. Interfaces are structurally and compositionally complex, consisting of gradients of extracellular matrix components, cell phenotypes as well as biochemical compositions and are important in mediating load transfer between the distinct orthopedic tissues during body movement. When an injury occurs at interface, it must be re-established to restore its function and stability. Due to the structural and compositional complexity found in interfaces, it is anticipated that they presuppose a concomitant increase in the complexity of the associated regenerative engineering approaches and scaffold designs to achieve successful interface regeneration and seamless integration of the engineered orthopedic tissues. Herein, we discuss the various bioinspired scaffold designs utilized to regenerate orthopedic tissue interfaces. First, we start with discussing the structure-function relationship at the interface. We then discuss the current understanding of the mechanism underlying interface regeneration, followed by discussing the current treatment available in the clinic to treat interface injuries. Lastly, we comprehensively discuss the state-of-the-art scaffold designs utilized to regenerate orthopedic tissue interfaces.
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Affiliation(s)
- Mohammed A Barajaa
- Connecticut Convergence Institute for Translation in Regenerative Engineering, University of Connecticut Health Center, Farmington, CT, 06030, USA
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, 06269, USA
| | - Lakshmi S Nair
- Connecticut Convergence Institute for Translation in Regenerative Engineering, University of Connecticut Health Center, Farmington, CT, 06030, USA
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, 06269, USA
- Raymond & Beverly Sackler Center for Biomedical, Biological, Physical & Engineering Sciences, University of Connecticut Health Center, Farmington, CT, 06030, USA
- Department of Orthopedic Surgery, University of Connecticut Health Center, Farmington, CT, 06030, USA
- Department of Materials Science & Engineering, University of Connecticut, Storrs, CT, 06269, USA
- Institute of Materials Science, University of Connecticut, Storrs, CT, USA
- Department of Chemical & Bimolecular Engineering, University of Connecticut, Storrs, CT, 06269, USA
| | - Cato T Laurencin
- Connecticut Convergence Institute for Translation in Regenerative Engineering, University of Connecticut Health Center, Farmington, CT, 06030, USA
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, 06269, USA
- Raymond & Beverly Sackler Center for Biomedical, Biological, Physical & Engineering Sciences, University of Connecticut Health Center, Farmington, CT, 06030, USA
- Department of Orthopedic Surgery, University of Connecticut Health Center, Farmington, CT, 06030, USA
- Department of Materials Science & Engineering, University of Connecticut, Storrs, CT, 06269, USA
- Institute of Materials Science, University of Connecticut, Storrs, CT, USA
- Department of Chemical & Bimolecular Engineering, University of Connecticut, Storrs, CT, 06269, USA
- Department of Craniofacial Sciences, School of Dental Medicine, University of Connecticut Health Center, Farmington, CT, 06030, USA
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Lu Z, Zhou S, Vaida J, Gao G, Stewart A, Parenti J, Yan L, Pei M. Unfavorable Contribution of a Tissue-Engineering Cartilage Graft to Osteochondral Defect Repair in Young Rabbits. Front Cell Dev Biol 2020; 8:595518. [PMID: 33195273 PMCID: PMC7658375 DOI: 10.3389/fcell.2020.595518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 10/12/2020] [Indexed: 11/17/2022] Open
Abstract
A stem cell-based tissue-engineering approach is a promising strategy for treatment of cartilage defects. However, there are conflicting data in the feasibility of using this approach in young recipients. A young rabbit model with an average age of 7.7 months old was used to evaluate the effect of a tissue-engineering approach on the treatment of osteochondral defects. Following in vitro evaluation of proliferation and chondrogenic capacity of infrapatellar fat pad-derived stem cells (IPFSCs) after expansion on either tissue culture plastic (TCP) or decellularized extracellular matrix (dECM), a premature tissue construct engineered from pretreated IPFSCs was used to repair osteochondral defects in young rabbits. We found that dECM expanded IPFSCs exhibited higher proliferation and chondrogenic differentiation compared to TCP expanded cells in both pellet and tissue construct culture systems. Six weeks after creation of bilateral osteochondral defects in the femoral trochlear groove of rabbits, the Empty group (left untreated) had the best cartilage resurfacing with the highest score in Modified O’Driscoll Scale (MODS) than the other groups; however, this score had no significant difference compared to that of 15-week samples, indicating that young rabbits stop growing cartilage once they reach 9 months old. Interestingly, implantation of premature tissue constructs from both dECM and TCP groups exhibited significantly improved cartilage repair at 15 weeks compared to those at six weeks (about 9 months old), indicating that a tissue-engineering approach is able to repair adult cartilage defects. We also found that implanted pre-labeled cells in premature tissue constructs were undetectable in resurfaced cartilage at both time points. This study suggests that young rabbits (less than 9 months old) might respond differently to the classical tissue-engineering approach that is considered as a potential treatment for cartilage defects in adult rabbits.
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Affiliation(s)
- Zhihua Lu
- Stem Cell and Tissue Engineering Laboratory, Department of Orthopaedics, West Virginia University, Morgantown, WV, United States.,Department of Orthopedics, Clinical Medical College of Yangzhou University, Subei People's Hospital of Jiangsu Province, Yangzhou, China
| | - Sheng Zhou
- Stem Cell and Tissue Engineering Laboratory, Department of Orthopaedics, West Virginia University, Morgantown, WV, United States
| | - Justin Vaida
- Stem Cell and Tissue Engineering Laboratory, Department of Orthopaedics, West Virginia University, Morgantown, WV, United States
| | - Gongming Gao
- Stem Cell and Tissue Engineering Laboratory, Department of Orthopaedics, West Virginia University, Morgantown, WV, United States
| | - Amanda Stewart
- Stem Cell and Tissue Engineering Laboratory, Department of Orthopaedics, West Virginia University, Morgantown, WV, United States
| | - Joshua Parenti
- Stem Cell and Tissue Engineering Laboratory, Department of Orthopaedics, West Virginia University, Morgantown, WV, United States
| | - Lianqi Yan
- Department of Orthopedics, Clinical Medical College of Yangzhou University, Subei People's Hospital of Jiangsu Province, Yangzhou, China
| | - Ming Pei
- Stem Cell and Tissue Engineering Laboratory, Department of Orthopaedics, West Virginia University, Morgantown, WV, United States.,WVU Cancer Institute, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, United States
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Lin CC, Chu CJ, Chou PH, Liang CH, Liang PI, Chang NJ. Beneficial Therapeutic Approach of Acellular PLGA Implants Coupled With Rehabilitation Exercise for Osteochondral Repair: A Proof of Concept Study in a Minipig Model. Am J Sports Med 2020; 48:2796-2807. [PMID: 32749853 DOI: 10.1177/0363546520940306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Osteochondral (OC) repair presents a significant challenge to clinicians. However, whether the use of acellular spongy poly(lactic-co-glycolic acid) (PLGA) scaffolding plus treadmill exercise as a rehabilitation program regenerates OC defects in a large-animal model has yet to be determined. HYPOTHESIS PLGA scaffolding plus treadmill exercise may offer improved OC repair for both high and low weightbearing regions in a minipig model. STUDY DESIGN Controlled laboratory study. METHODS A total of 9 mature minipigs (18 knees) were randomly divided into the treadmill exercise (TRE) group or sedentary (SED) group. All pigs received critically sized OC defects in a higher weightbearing region of the medial condyle and a lower weightbearing region of the trochlear groove. In each minipig, a PLGA scaffold was placed in the defect of the right knee (PLGA subgroup), and the defect of the left knee was untreated (empty defect [ED] subgroup). The TRE group performed exercises in 3 phases: warm-up, 3 km/h for 5 minutes; main exercise, 4 km/h for 20 minutes; and cool-down, 3 km/h for 5 minutes. The total duration was about 30 minutes whenever possible. The SED group was allowed free cage activity. RESULTS At 6 months, the TRE-PLGA group showed the highest gross morphology scores and regenerated a smooth articular surface covered with new hyaline-like tissue, while the defects of the other groups remained and contained nontransparent tissue. Histologically, the TRE-PLGA group also revealed sound OC integration, chondrocyte-like cells embedded in lacunae, abundant glycosaminoglycans, a sound collagen structure, and modest inflammatory cells with an inflammatory response (ie, tumor necrosis factor-α, interleukin-6). In addition, in the medial condyle region, the TRE-PLGA group (31.80 ± 3.03) had the highest total histological scores (TRE-ED: 20.20 ± 5.76; SED-PLGA: 10.25 ± 6.24; SED-ED: 11.75 ± 6.50; P = .004). In the trochlear groove region, the TRE-PLGA group (30.20 ± 6.42) displayed significantly higher total histological scores (TRE-ED: 19.60 ± 7.00; SED-PLGA: 10.00 ± 5.42; SED-ED: 11.25 ± 5.25; P = .006). In contrast, the SED-PLGA and SED-ED groups revealed an irregular surface with abrasion, fibrotic tissue with an empty void and inflammatory cells, disorganized collagen fibers, and less glycosaminoglycan deposition. Micro-computed tomography analysis revealed that the TRE-PLGA group had integrated OC interfaces with continued remodeling in the subchondral bone. Furthermore, comparing the 2 defect regions, no statistically significant differences in cartilage regeneration were detected, indicating the suitability of this regenerative approach for both high and low weightbearing regions. CONCLUSION Implanting an acellular PLGA scaffold plus treadmill exercise promoted articular cartilage regeneration for both high and low weightbearing regions in minipigs. CLINICAL RELEVANCE This study suggests the use of a cell-free porous PLGA scaffold and treadmill exercise rehabilitation as an alternative therapeutic strategy for OC repair in a large-animal knee joint model. This combined effect may pave the way for biomaterials and exercise regimens in the application of OC repair.
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Affiliation(s)
- Chih-Chan Lin
- Department of Medical Research, Chi Mei Medical Center, Tainan City, Taiwan
| | - Chih-Jou Chu
- Department of Sports Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Pei-Hsi Chou
- Department of Sports Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.,PhD Program in Biomedical Engineering, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Chun-Hao Liang
- Department of Sports Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Peir-In Liang
- Department of Pathology, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Nai-Jen Chang
- Department of Sports Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.,PhD Program in Biomedical Engineering, Kaohsiung Medical University, Kaohsiung City, Taiwan.,Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung City, Taiwan
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Ayan B, Wu Y, Karuppagounder V, Kamal F, Ozbolat IT. Aspiration-assisted bioprinting of the osteochondral interface. Sci Rep 2020; 10:13148. [PMID: 32753630 PMCID: PMC7403300 DOI: 10.1038/s41598-020-69960-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/22/2020] [Indexed: 11/09/2022] Open
Abstract
Osteochondral defects contain damage to both the articular cartilage and underlying subchon- dral bone, which remains a significant challenge in orthopedic surgery. Layered structure of bone, cartilage and the bone-cartilage interface must be taken into account in the case of biofabrication of the osteochondral (OC) interface. In this study, a dual layered OC interface was bioprinted using a newly developed aspiration-assisted bioprinting (AAB) technique, which has been the first time that scaffold-free bioprinting was applied to OC interface engineering. Tissue spheroids, made of human adipose-derived stem cells (ADSCs), were differentiated in three dimensions (3D) into chondrogenic and osteogenic spheroids, which were confirmed by immunostaining and histology qualitatively, and biochemistry assays and gene expression, quantitatively. Remarkably, the OC interface was bioprinted by accurate positioning of a layer of osteogenic spheroids onto a sacrificial alginate support followed by another layer of chondrogenic spheroids overlaid by the same support. Spheroids in individual zones fused and the maintenance of phenotypes in both zones confirmed the successful biofabrication of the histomorphologically-relevant OC interface. The biofabrication of OC tissue model without the use of polymeric scaffolds unveils great potential not only in regenerative medicine but also in drug testing and disease modeling for osteoarthritis.
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Affiliation(s)
- Bugra Ayan
- Engineering Science and Mechanics Department, Penn State University, University Park, PA, 16802, USA
- The Huck Institutes of the Life Sciences, Penn State University, University Park, PA, 16802, USA
| | - Yang Wu
- Engineering Science and Mechanics Department, Penn State University, University Park, PA, 16802, USA
- The Huck Institutes of the Life Sciences, Penn State University, University Park, PA, 16802, USA
- School of Mechanical Engineering and Automation, Harbin Institute of Technology, Shenzhen, 518055, China
| | - Vengadeshprabhu Karuppagounder
- Center for Orthopedic Research and Translational Sciences, Department of Orthopedics and Re-Habilitation, Penn State University, Hershey, PA, 17033, USA
| | - Fadia Kamal
- Center for Orthopedic Research and Translational Sciences, Department of Orthopedics and Re-Habilitation, Penn State University, Hershey, PA, 17033, USA
| | - Ibrahim T Ozbolat
- Engineering Science and Mechanics Department, Penn State University, University Park, PA, 16802, USA.
- The Huck Institutes of the Life Sciences, Penn State University, University Park, PA, 16802, USA.
- Biomedical Engineering Department, Penn State University, University Park, PA, 16802, USA.
- Materials Research Institute, Penn State University, University Park, PA, 16802, USA.
- Department of Neurosurgery, Penn State University, Hershey, PA, 17033, USA.
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18
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Shivji FS, Mumith A, Yasen S, Melton JT, Wilson AJ. Treatment of focal chondral lesions in the knee using a synthetic scaffold plug: Long-term clinical and radiological results. J Orthop 2020; 20:12-16. [PMID: 32021049 DOI: 10.1016/j.jor.2020.01.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 01/12/2020] [Indexed: 11/18/2022] Open
Abstract
The management of symptomatic articular cartilage lesions, especially in the young, fit individual remains an area of considerable controversy. Articular cartilage repair or reconstruction techniques may offer these patients alternatives to arthroplasty. The TruFit™ plug is a synthetic biphasic polymer scaffold that is designed for implantation at the site of a focal chondral defect. The aim of this study is to report the long-term clinical and radiological outcomes of patients treated with the TruFit™ plug for chondral defects within the knee. 11 patients underwent TruFit™ plug implantation. Long-term outcome scores were available for 6 patients at a mean follow up of 121 months (SD 12.0 months, 1 patient unavailable and 4 excluded after arthroplasty surgery). There was no statistically significant improvements in any score although all scores did improve. At a mean radiographic follow up of 70 months (17-113) of 9 patients, the mean MOCART score was 22.2 (SD 15.6). All patients had incomplete or no evidence of plug incorporation and persistent chondral loss. Based on these results, we do not recommend the use of the TruFit™ plug.
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Affiliation(s)
- Faiz S Shivji
- Basingstoke & North Hampshire Hospital, Aldermaston Road, Basingstoke, RG24 9NA, UK
| | - Aadil Mumith
- Basingstoke & North Hampshire Hospital, Aldermaston Road, Basingstoke, RG24 9NA, UK
| | - Sam Yasen
- Basingstoke & North Hampshire Hospital, Aldermaston Road, Basingstoke, RG24 9NA, UK
| | - Joel Tk Melton
- Basingstoke & North Hampshire Hospital, Aldermaston Road, Basingstoke, RG24 9NA, UK
| | - Adrian J Wilson
- Basingstoke & North Hampshire Hospital, Aldermaston Road, Basingstoke, RG24 9NA, UK
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Grier WK, Sun Han Chang RA, Ramsey MD, Harley BA. The influence of cyclic tensile strain on multi-compartment collagen-GAG scaffolds for tendon-bone junction repair. Connect Tissue Res 2019; 60:530-543. [PMID: 31007094 PMCID: PMC6706312 DOI: 10.1080/03008207.2019.1601183] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Background: Orthopedic injuries often occur at the interface between soft tissues and bone. The tendon-bone junction (TBJ) is a classic example of such an interface. Current clinical strategies for TBJ injuries prioritize mechanical reattachment over regeneration of the native interface, resulting in poor outcomes. The need to promote regenerative healing of spatially-graded tissues inspires our effort to develop new tissue engineering technologies that replicate features of the spatially-graded extracellular matrix and strain profiles across the native TBJ. Materials and Methods: We recently described a biphasic collagen-glycosaminoglycan (CG) scaffold containing distinct compartment with divergent mineral content and structural alignment (isotropic vs. anisotropic) linked by a continuous interface zone to mimic structural and compositional features of the native TBJ. Results: Here, we report application of cyclic tensile strain (CTS) to the scaffold via a bioreactor leads to non-uniform strain profiles across the spatially-graded scaffold. Further, combinations of CTS and matrix structural features promote rapid, spatially-distinct differentiation profiles of human bone marrow-derived mesenchymal stem cells (MSCs) down multiple osteotendinous lineages. CTS preferentially upregulates MSC activity and tenogenic differentiation in the anisotropic region of the scaffold. This work demonstrates a tissue engineering approach that couples instructive biomaterials with cyclic tensile stimuli to promote regenerative healing of orthopedic interfaces.
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Affiliation(s)
- William K. Grier
- Dept. Chemical and Biomolecular Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801
| | - Raul A. Sun Han Chang
- Dept. Chemical and Biomolecular Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801
| | - Matthew D. Ramsey
- Dept. Chemical and Biomolecular Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801
| | - Brendan A.C. Harley
- Dept. Chemical and Biomolecular Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801,Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801
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Tanase CE, Qutachi O, White LJ, Shakesheff KM, McCaskie AW, Best SM, Cameron RE. Targeted protein delivery: carbodiimide crosslinking influences protein release from microparticles incorporated within collagen scaffolds. Regen Biomater 2019; 6:279-287. [PMID: 31616565 PMCID: PMC6783698 DOI: 10.1093/rb/rbz015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 03/11/2019] [Indexed: 12/17/2022] Open
Abstract
Tissue engineering response may be tailored via controlled, sustained release of active agents from protein-loaded degradable microparticles incorporated directly within three-dimensional (3D) ice-templated collagen scaffolds. However, the effects of covalent crosslinking during scaffold preparation on the availability and release of protein from the incorporated microparticles have not been explored. Here, we load 3D ice-templated collagen scaffolds with controlled additions of poly-(DL-lactide-co-glycolide) microparticles. We probe the effects of subsequent N-(3-dimethylaminopropyl)-N'-ethylcarbodiimide hydrochloride crosslinking on protein release, using microparticles with different internal protein distributions. Fluorescein isothiocyanate labelled bovine serum albumin is used as a model protein drug. The scaffolds display a homogeneous microparticle distribution, and a reduction in pore size and percolation diameter with increased microparticle addition, although these values did not fall below those reported as necessary for cell invasion. The protein distribution within the microparticles, near the surface or more deeply located within the microparticles, was important in determining the release profile and effect of crosslinking, as the surface was affected by the carbodiimide crosslinking reaction applied to the scaffold. Crosslinking of microparticles with a high proportion of protein at the surface caused both a reduction and delay in protein release. Protein located within the bulk of the microparticles, was protected from the crosslinking reaction and no delay in the overall release profile was seen.
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Affiliation(s)
- Constantin Edi Tanase
- Department of Materials Science and Metallurgy, University of Cambridge, Cambridge Centre for Medical Materials, Cambridge, 27, Charles Babbage Road, UK
| | - Omar Qutachi
- Centre for Biomolecular Sciences, School of Pharmacy, University of Nottingham, University Park, Nottingham, UK
| | - Lisa J White
- Centre for Biomolecular Sciences, School of Pharmacy, University of Nottingham, University Park, Nottingham, UK
| | - Kevin M Shakesheff
- Centre for Biomolecular Sciences, School of Pharmacy, University of Nottingham, University Park, Nottingham, UK
| | - Andrew W McCaskie
- Division of Trauma & Orthopaedic Surgery, Department of Surgery, University of Cambridge, Addenbrooke's Hospital, Hills Road, Cambridge, UK
| | - Serena M Best
- Department of Materials Science and Metallurgy, University of Cambridge, Cambridge Centre for Medical Materials, Cambridge, 27, Charles Babbage Road, UK
| | - Ruth E Cameron
- Department of Materials Science and Metallurgy, University of Cambridge, Cambridge Centre for Medical Materials, Cambridge, 27, Charles Babbage Road, UK
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Ansari S, Khorshidi S, Karkhaneh A. Engineering of gradient osteochondral tissue: From nature to lab. Acta Biomater 2019; 87:41-54. [PMID: 30721785 DOI: 10.1016/j.actbio.2019.01.071] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 12/22/2018] [Accepted: 01/31/2019] [Indexed: 12/11/2022]
Abstract
The osteochondral tissue is an interface between two distinct tissues: articular cartilage and bone. These two tissues are significantly diverse with regard to their chemical compositions, mechanical properties, structure, electrical properties, and the amount of nutrient and oxygen consumption. Thus, transition from the surface of the articular cartilage to the subchondral bone needs to face several smooth gradients. These gradients are imperative to study to generate a scaffold suitable for the reconstruction of the cartilaginous and osseous layers of a defected osteochondral tissue, simultaneously. The aim of this review is to peruse the alternation of biochemical, biomechanical, structural, electrical, and metabolic properties of the osteochondral tissue moving from the surface of the articular cartilage to the subchondral bone. Moreover, this review also discusses currently developed approaches and ideal techniques with a focus on gradients present in the interface of the cartilage and bone. STATEMENT OF SIGNIFICANCE: The submitted review paper entitled as "Engineering of the gradient osteochondral tissue: from nature to lab" is a complete review with regard to the osteochondral tissue and transition of different properties between the cartilage and bone tissues. Moreover, previous studies on the osteochondral tissue engineering have been reviewed in this paper. This complete information can be a valuable and useful source for current and future researchers and scientists. Considering the scope of the submitted paper, Acta Biomaterialia would be a suitable journal for publishing this article.
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Mesenchymal stem cell-loaded porous tantalum integrated with biomimetic 3D collagen-based scaffold to repair large osteochondral defects in goats. Stem Cell Res Ther 2019; 10:72. [PMID: 30837004 PMCID: PMC6402115 DOI: 10.1186/s13287-019-1176-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 01/28/2019] [Accepted: 02/12/2019] [Indexed: 01/09/2023] Open
Abstract
Background The body is unable to repair and regenerate large area bone defects. Moreover, the repair capacity of articular cartilage is very limited. There has long been a lack of effective treatments for osteochondral lesions. The engineered tissue with biphase synthetic for osteochondral repair has become one of the hot research fields over the past few years. In this study, an integrated biomanufacturing platform was constructed with bone marrow mesenchymal stem cells (BMSCs)/porous tantalum (pTa) associated with chondrocytes/collagen membranes (CM) to repair large osteochondral defects in load-bearing areas of goats. Methods Twenty-four goats with a large osteochondral defect in the femoral heads of the left hind legs were randomly divided into three groups: eight were treated with chondrocytes/CM-BMSCs/pTa, eight were treated with pure CM-pTa composite, and the other eight goats were untreated. The repair effect was assessed by X-ray, gross observation, and histomorphology for 16 weeks after the operation. In addition, the biocompatibility of chondrocytes/CM-BMSCs/pTa was observed by flow cytometry, CCK8, immunocytochemistry, and Q-PCR. The characteristics of the chondrocytes/CM-BMSCs/pTa were evaluated using both scanning electron microscopy and mechanical testing machine. Results The integrated repair material consists of pTa, injectable fibrin sealant, and CM promoted adhesion and growth of BMSCs and chondrocytes. pTa played an important role in promoting the differentiation of BMSCs into osteoblasts. Three-dimensional CM maintained the phenotype of chondrocytes successfully and expressed chondrogenic genes highly. The in vivo study showed that after 16 weeks from implantation, osteochondral defects in almost half of the femoral heads had been successfully repaired by BMSC-loaded pTa associated with biomimetic 3D collagen-based scaffold. Conclusions The chondrocytes/CM-BMSCs/pTa demonstrated significant therapeutic efficacy in goat models of large osteochondral defect. This provides a novel therapeutic strategy for large osteochondral lesions in load-bearing areas caused by severe injury, necrosis, infection, degeneration, and tumor resection with a high profile of safety, effectiveness, and simplicity.
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Chitosan based polymer/bioglass composites for tissue engineering applications. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2019; 96:955-967. [DOI: 10.1016/j.msec.2018.12.026] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 11/09/2018] [Accepted: 12/09/2018] [Indexed: 01/12/2023]
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Silicate-based bioceramic scaffolds for dual-lineage regeneration of osteochondral defect. Biomaterials 2019; 192:323-333. [DOI: 10.1016/j.biomaterials.2018.11.025] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 11/12/2018] [Accepted: 11/14/2018] [Indexed: 01/26/2023]
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Lin TH, Wang HC, Cheng WH, Hsu HC, Yeh ML. Osteochondral Tissue Regeneration Using a Tyramine-Modified Bilayered PLGA Scaffold Combined with Articular Chondrocytes in a Porcine Model. Int J Mol Sci 2019; 20:ijms20020326. [PMID: 30650528 PMCID: PMC6359257 DOI: 10.3390/ijms20020326] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 01/09/2019] [Accepted: 01/11/2019] [Indexed: 12/28/2022] Open
Abstract
Repairing damaged articular cartilage is challenging due to the limited regenerative capacity of hyaline cartilage. In this study, we fabricated a bilayered poly (lactic-co-glycolic acid) (PLGA) scaffold with small (200–300 μm) and large (200–500 μm) pores by salt leaching to stimulate chondrocyte differentiation, cartilage formation, and endochondral ossification. The scaffold surface was treated with tyramine to promote scaffold integration into native tissue. Porcine chondrocytes retained a round shape during differentiation when grown on the small pore size scaffold, and had a fibroblast-like morphology during transdifferentiation in the large pore size scaffold after five days of culture. Tyramine-treated scaffolds with mixed pore sizes seeded with chondrocytes were pressed into three-mm porcine osteochondral defects; tyramine treatment enhanced the adhesion of the small pore size scaffold to osteochondral tissue and increased glycosaminoglycan and collagen type II (Col II) contents, while reducing collagen type X (Col X) production in the cartilage layer. Col X content was higher for scaffolds with a large pore size, which was accompanied by the enhanced generation of subchondral bone. Thus, chondrocytes seeded in tyramine-treated bilayered scaffolds with small and large pores in the upper and lower parts, respectively, can promote osteochondral regeneration and integration for articular cartilage repair.
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Affiliation(s)
- Tzu-Hsiang Lin
- Department of Biomedical Engineering, National Cheng Kung University, 1 University Rd., Tainan 701, Taiwan.
| | - Hsueh-Chun Wang
- Department of Biomedical Engineering, National Cheng Kung University, 1 University Rd., Tainan 701, Taiwan.
| | - Wen-Hui Cheng
- Department of Biomedical Engineering, National Cheng Kung University, 1 University Rd., Tainan 701, Taiwan.
| | - Horng-Chaung Hsu
- Department of Orthopedics, China Medical University Hospital, 2 Yude Rd., Taichung 40447, Taiwan.
| | - Ming-Long Yeh
- Department of Biomedical Engineering, National Cheng Kung University, 1 University Rd., Tainan 701, Taiwan.
- Medical Device Innovation Center, National Cheng Kung University, 1 University Rd., Tainan 701, Taiwan.
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Ahmad Z, Al-Wattar Z, Rushton N. Tissue Engineering for the Ovine Rotator Cuff: Surgical Anatomy, Approach, Implantation and Histology Technique, along with Review of Literature. J INVEST SURG 2018; 33:147-158. [PMID: 30339484 DOI: 10.1080/08941939.2018.1483446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Aim: Tissue engineering is a contemporary topic, which is widely discussed in shoulder surgery. The preclinical success of tissue engineering has not yet fully translated to clinical studies. In this study, we present our experience in this subject and discuss measurements to analyze the sheep tissue as comparative model. We also present a comprehensive systematic review of the literature in relation to tissue engineering and rotator cuff. Method: We studied the anatomy, histology and surgical approach of 24 infraspinatus tendons specimens in sheep and focused on certain measurements such as: (1) size of the normal tendon; (2) diameter of the normal footprint; and (3) bone hardness of the footprint using a durometer. Blood from six sheep was obtained and processed to produce platelet rich plasma using both the Harvest Smartprep and Cascade kit. We then outlined an approach to the infraspinatus tendon footprint in preparation for implantation of a biological augmentation material, which was repaired using a double row technique. This was followed by a histological analysis. Results: The average measurements of the footprint were 21 mm ×21 mm, the tendon length was 35.1 mm and the width proximal and distal was 21.9 and 14 mm, respectively. The average bone hardness at the 12, 3, 6, and 9 o'clock position was 64.1, 52.3, 50.1, and 37.7 respectively. Central footprint and lateral edge hardness was 44.8 and 43.4. Only the Harvest Smartprep and using a modified method, was able to produce a platelet concentration factor of 4. The Cascade method was unable to concentrate sheep blood. Conclusion: The sheep model is a suitable tissue for studying the rotator cuff. The researcher must be aware of certain interspecies caveats. Clinical tissue engineering and surgical techniques must be modified in order to be suitable when using sheep model.
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Affiliation(s)
- Zafar Ahmad
- Orthopaedic Research Unit, Department of Surgery, University Hospital Southampton, Southampton, UK
| | | | - Neil Rushton
- Orthopaedic Research Unit, Department of Surgery, University Hospital Southampton, Southampton, UK
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Tamaddon M, Liu C. Enhancing Biological and Biomechanical Fixation of Osteochondral Scaffold: A Grand Challenge. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1059:255-298. [PMID: 29736578 DOI: 10.1007/978-3-319-76735-2_12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Osteoarthritis (OA) is a degenerative joint disease, typified by degradation of cartilage and changes in the subchondral bone, resulting in pain, stiffness and reduced mobility. Current surgical treatments often fail to regenerate hyaline cartilage and result in the formation of fibrocartilage. Tissue engineering approaches have emerged for the repair of cartilage defects and damages to the subchondral bones in the early stage of OA and have shown potential in restoring the joint's function. In this approach, the use of three-dimensional scaffolds (with or without cells) provides support for tissue growth. Commercially available osteochondral (OC) scaffolds have been studied in OA patients for repair and regeneration of OC defects. However, some controversial results are often reported from both clinical trials and animal studies. The objective of this chapter is to report the scaffolds clinical requirements and performance of the currently available OC scaffolds that have been investigated both in animal studies and in clinical trials. The findings have demonstrated the importance of biological and biomechanical fixation of the OC scaffolds in achieving good cartilage fill and improved hyaline cartilage formation. It is concluded that improving cartilage fill, enhancing its integration with host tissues and achieving a strong and stable subchondral bone support for overlying cartilage are still grand challenges for the early treatment of OA.
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Affiliation(s)
- Maryam Tamaddon
- Institute of Orthopaedics & Musculoskeletal Science, Division of Surgery & Interventional Science, University College London, Royal National Orthopaedic Hospital, Stanmore, UK
| | - Chaozong Liu
- Institute of Orthopaedics & Musculoskeletal Science, Division of Surgery & Interventional Science, University College London, Royal National Orthopaedic Hospital, Stanmore, UK.
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Synthetic Materials for Osteochondral Tissue Engineering. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1058:31-52. [DOI: 10.1007/978-3-319-76711-6_2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Khorshidi S, Karkhaneh A. A review on gradient hydrogel/fiber scaffolds for osteochondral regeneration. J Tissue Eng Regen Med 2018; 12:e1974-e1990. [PMID: 29243352 DOI: 10.1002/term.2628] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Revised: 07/17/2017] [Accepted: 11/27/2017] [Indexed: 12/31/2022]
Abstract
Osteochondral tissue regeneration is a complicated field due to the distinct properties and healing potential of osseous and chondral phases. In a natural osteochondral region, the composition, mechanics, and structure vary smoothly from bony to cartilaginous phase. Therefore, a homogeneous scaffold cannot satisfy the complexity of the osteochondral matrix. In essence, a natural extracellular matrix is composed of fibrous proteins elongated into a gelatinous background. A hydrogel/fiber scaffold possessing gradient in both phases would be of the utmost interest to imitate tissue arrangement of a native osteochondral interface. However, there are limited research works that exploit hydrogel/fiber scaffolds for osteochondral restoration. In the present review, currently used fibrous or gelatinous scaffolds for osteochondral damages are discussed. Moreover, superiority of using gradient hydrogel/fiber composites for osteochondral regeneration and practical approaches to develop those scaffolds is debated.
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Affiliation(s)
- Sajedeh Khorshidi
- Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
| | - Akbar Karkhaneh
- Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran
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Pereira DR, Reis RL, Oliveira JM. Layered Scaffolds for Osteochondral Tissue Engineering. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1058:193-218. [DOI: 10.1007/978-3-319-76711-6_9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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McCarrel TM, Pownder SL, Gilbert S, Koff MF, Castiglione E, Saska RA, Bradica G, Fortier LA. Two-Year Evaluation of Osteochondral Repair with a Novel Biphasic Graft Saturated in Bone Marrow in an Equine Model. Cartilage 2017; 8:406-416. [PMID: 28934879 PMCID: PMC5613894 DOI: 10.1177/1947603516675913] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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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Affiliation(s)
- Taralyn M. McCarrel
- 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
| | | | | | | | | | - Ryan A. Saska
- DSM Biomedical d/b/a Kensey Nash Corporation, Exton, PA, USA
| | - Gino Bradica
- DSM Biomedical d/b/a Kensey Nash Corporation, Exton, PA, USA
| | - Lisa A. Fortier
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY, USA,Lisa A. Fortier, VMC C3-181 Cornell University, College of Veterinary Medicine, Ithaca, NY 14853, USA.
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Carfì Pavia F, Ciappa M, Lepedda A, Fiorentino SM, Rigogliuso S, Brucato V, Formato M, Ghersi G, La Carrubba V. A poly-L-lactic acid/ collagen/glycosaminoglycan matrix for tissue engineering applications. J CELL PLAST 2017. [DOI: 10.1177/0021955x17695093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Adhesion of tissue cells to biomaterials is a prerequisite of paramount importance for the effectiveness of a tissue engineering construct (cell and scaffolds). Functionalization of polymeric scaffolds with organic polymers, such as collagen or proteoglycans, is a promising approach in order to improve the cytocompatibility. As a matter of fact, organic polymers, isolated directly from the extracellular matrix, contain a multitude of surface ligand (fibronectin, laminin, vitronectin) and arginine–glycine–aspartic acid-containing peptides that promote cell adhesion. In tissue engineering, the combination of organic and synthetic polymers gives rise to scaffolds characterized simultaneously by the mechanical strength of synthetic materials and the biocompatibility of natural materials. In this work, porous poly-L-lactide acid scaffolds were functionalized with a synthetic collagen–glycosaminoglycans matrix in order to improve cell adhesion. For this purpose, a protocol for collagen–glycosaminoglycans conjugation into the pores of the scaffolds was set up. Moreover, an innovative protocol for the quantification of the conjugated glycosaminoglycans inside the scaffolds was created and adopted. The results have confirmed the effectiveness of the developed protocol: a collagen–glycosaminoglycans conjugation, with an efficiency of about 21% was obtained inside the scaffold. Moreover, SEM analysis highlighted the presence of the homogeneous synthetic matrix into the bulk of porous scaffolds. Finally, cell culture assays carried out by utilizing mouse embryonic fibroblasts showed that cell proliferation on poly-L-lactide acid-collagen–glycosaminoglycans scaffold is higher than on poly-L-lactide acid collagen scaffold (utilized as control). Therefore, it can be stated that the presence of glycosaminoglycans not only increases the mechanical strength of the matrix, thanks to their cross-linking effect, but also it seems to lead to a more significant cell growth. Overall, it is reasonable to state that the concerned protocol may be proposed as a reliable route to increase the rate of proliferation and in some cases to stimulate the cell differentiation in tissue engineering devices.
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Affiliation(s)
- F Carfì Pavia
- Civil Environmental Aerospace and Materials Engineering Department, University of Palermo, Palermo, Italy
| | - M Ciappa
- Biological Chemical and Pharmaceutical Science and Technologies Department, University of Palermo, Palermo, Italy
| | - A Lepedda
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - SM Fiorentino
- Department of Engineering and Architecture, University of Trieste, Trieste, Italy
| | - S Rigogliuso
- Biological Chemical and Pharmaceutical Science and Technologies Department, University of Palermo, Palermo, Italy
| | - V Brucato
- Civil Environmental Aerospace and Materials Engineering Department, University of Palermo, Palermo, Italy
| | - M Formato
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - G Ghersi
- Biological Chemical and Pharmaceutical Science and Technologies Department, University of Palermo, Palermo, Italy
| | - V La Carrubba
- Civil Environmental Aerospace and Materials Engineering Department, University of Palermo, Palermo, Italy
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Sing SL, Wang S, Agarwala S, Wiria FE, Ha TMH, Yeong WY. Fabrication of titanium based biphasic scaffold using selective laser melting and collagen immersion. Int J Bioprint 2017; 3:007. [PMID: 33094182 PMCID: PMC7575621 DOI: 10.18063/iib.2017.01.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 12/21/2016] [Indexed: 11/23/2022] Open
Abstract
Tissue engineering approaches have been adopted to address challenges in osteochondral tissue regeneration. Single phase scaffolds, which consist of only one single material throughout the whole structure, have been used extensively in these tissue engineering approaches. However, a single phase scaffold is insufficient in providing all the properties required for regeneration and repair of osteochondral defects. Biphasic scaffolds with two distinct phases of titanium/type 1 c ollagen and titanium-tantalum/type 1 collagen were developed for the first time using selective laser melting and collagen infiltration. Observation of the biphasic scaffolds demonstrated continuous interface between the two phases and mechanical characterization of the metallic scaffolds support the feasibility of the newly developed scaffolds for tissue engineering in osteochondral defects.
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Affiliation(s)
- Swee Leong Sing
- SIMTech-NTU Joint Laboratory (3D Additive Manufacturing), Nanyang Technological University, 65A Nanyang Drive, Singapore 637333.,Singapore Centre for 3D Printing, School of Mechanical & Aerospace Engineering, Nanyang Technological University, 2A Nanyang Link, Singapore 637372
| | - Shuai Wang
- Singapore Centre for 3D Printing, School of Mechanical & Aerospace Engineering, Nanyang Technological University, 2A Nanyang Link, Singapore 637372
| | - Shweta Agarwala
- Singapore Centre for 3D Printing, School of Mechanical & Aerospace Engineering, Nanyang Technological University, 2A Nanyang Link, Singapore 637372
| | - Florencia Edith Wiria
- SIMTech-NTU Joint Laboratory (3D Additive Manufacturing), Nanyang Technological University, 65A Nanyang Drive, Singapore 637333.,Singapore Institute of Manufacturing Technology (SIMTech) @ NTU, 73 Nanyang Drive, Singapore 637662
| | - Thi Mai Hoa Ha
- Singapore Institute of Manufacturing Technology (SIMTech) @ NTU, 73 Nanyang Drive, Singapore 637662
| | - Wai Yee Yeong
- SIMTech-NTU Joint Laboratory (3D Additive Manufacturing), Nanyang Technological University, 65A Nanyang Drive, Singapore 637333.,Singapore Centre for 3D Printing, School of Mechanical & Aerospace Engineering, Nanyang Technological University, 2A Nanyang Link, Singapore 637372
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O'Reilly A, Kelly DJ. A Computational Model of Osteochondral Defect Repair Following Implantation of Stem Cell-Laden Multiphase Scaffolds. Tissue Eng Part A 2017; 23:30-42. [DOI: 10.1089/ten.tea.2016.0175] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Adam O'Reilly
- Trinity Centre for Bioengineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Daniel John Kelly
- Trinity Centre for Bioengineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
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Pre-clinical and Clinical Management of Osteochondral Lesions. REGENERATIVE STRATEGIES FOR THE TREATMENT OF KNEE JOINT DISABILITIES 2017. [DOI: 10.1007/978-3-319-44785-8_8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Kon E, Robinson D, Verdonk P, Drobnic M, Patrascu JM, Dulic O, Gavrilovic G, Filardo G. A novel aragonite-based scaffold for osteochondral regeneration: early experience on human implants and technical developments. Injury 2016; 47 Suppl 6:S27-S32. [PMID: 28040083 DOI: 10.1016/s0020-1383(16)30836-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Chondral and osteochondral lesions represent a debilitating disease. Untreated lesions remain a risk factor for more extensive joint damage. The objective of this clinical study is to evaluate safety and early results of an aragonite-based scaffold used for osteochondral unit repair, by analysing both clinical outcome and MRI results, as well as the benefits of the procedure optimization through novel tapered shaped implants. METHODS A crystalline aragonite bi-phasic scaffold was implanted in patients affected by focal chondral-osteochondral knee lesions of the condyle and trochlea. Twenty-one patients (17 men, 4 women with a mean age of 31.0 ± 8.6 years) without severe OA received tapered shaped implants for the treatment of 2.5 ±1.7 cm2 sized defects. The control group consisted of 76 patients selected according to the same criteria from a database of patients who previously underwent implantation of cylindrical-shaped implants. The clinical outcome of all patients was evaluated with the IKDC subjective score, the Lysholm score, and all 5 KOOS subscales administered preoperatively and at 6 and 12 months after surgery, while MRI evaluation was performed at the 12 month follow-up. RESULTS A statistically significant improvement in all clinical scores was documented both in the tapered implants and the cylindrical group. No difference could be detected in the comparison between the improvement obtained with the two implant types, neither in the clinical nor in imaging evaluations. A difference could be detected instead in terms of revision rate, which was lower in the tapered implant group with no implant removal - 0% vs 8/76-10.5% failures in the cylindrical implants. CONCLUSIONS This study highlighted both safety and potential of a novel aragonite-based scaffold for the treatment of chondral and osteochondral lesions in humans. A tapered shape relative to the cylindrical shaped implant design, improved the scaffold's safety profile. Tapered scaffolds maintain the clinical improvement observed in cylindrical implants while reducing the postoperative risk of revision surgery. This aragonite-based implant was associated with a significant clinical improvement at the 12 month follow-up. Moreover, MRI findings revealed graft integration with good bone and cartilage formation.
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Affiliation(s)
- Elizaveta Kon
- NanoBiotecnology Lab, I Clinic - Rizzoli Orthopaedic Institute, Bologna, Italy.
| | - Dror Robinson
- Department of Orthopedics, Hasharon Hospital affiliated with Tel Aviv University, Rabin Medical Center, Petah Tikwa, Israel
| | - Peter Verdonk
- Antwerp Orthopaedic Center, Monica Hospitals, Stevenslei, Deurne, Belgium; Department of Orthopaedic Surgery, Faculty of Medicine, Antwerp University, Wilrijkstraat, Edegem, Belgium
| | - Matej Drobnic
- Department of Orthopedic Surgery, University Medical Centre Ljubljana, Slovenia
| | - Jenel Mariano Patrascu
- Spitalul Clinic Judeţean de Urgenţă "Pius Brînzeu" Timişoara Bulevardul Liviu Rebreanu, Timişoara, Romania
| | | | | | - Giuseppe Filardo
- NanoBiotecnology Lab, I Clinic - Rizzoli Orthopaedic Institute, Bologna, Italy
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Levingstone TJ, Ramesh A, Brady RT, Brama PA, Kearney C, Gleeson JP, O'Brien FJ. Cell-free multi-layered collagen-based scaffolds demonstrate layer specific regeneration of functional osteochondral tissue in caprine joints. Biomaterials 2016; 87:69-81. [DOI: 10.1016/j.biomaterials.2016.02.006] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 01/31/2016] [Accepted: 02/04/2016] [Indexed: 12/24/2022]
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Lee N, Robinson J, Lu H. Biomimetic strategies for engineering composite tissues. Curr Opin Biotechnol 2016; 40:64-74. [PMID: 27010653 DOI: 10.1016/j.copbio.2016.03.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 02/27/2016] [Accepted: 03/04/2016] [Indexed: 01/22/2023]
Abstract
The formation of multiple tissue types and their integration into composite tissue units presents a frontier challenge in regenerative engineering. Tissue-tissue synchrony is crucial in providing structural support for internal organs and enabling daily activities. This review highlights the state-of-the-art in composite tissue scaffold design, and explores how biomimicry can be strategically applied to avoid over-engineering the scaffold. Given the complexity of biological tissues, determining the most relevant parameters for recapitulating native structure-function relationships through strategic biomimicry will reduce the burden for clinical translation. It is anticipated that these exciting efforts in composite tissue engineering will enable integrative and functional repair of common soft tissue injuries and lay the foundation for total joint or limb regeneration.
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Affiliation(s)
- Nancy Lee
- Biomaterials and Interface Tissue Engineering Laboratory, Department of Biomedical Engineering, Columbia University, New York, NY 10027, United States
| | - Jennifer Robinson
- Biomaterials and Interface Tissue Engineering Laboratory, Department of Biomedical Engineering, Columbia University, New York, NY 10027, United States; Division of Orthodontics, College of Dental Medicine, Columbia University, New York, NY 10032, United States
| | - Helen Lu
- Biomaterials and Interface Tissue Engineering Laboratory, Department of Biomedical Engineering, Columbia University, New York, NY 10027, United States.
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Multi-layered collagen-based scaffolds for osteochondral defect repair in rabbits. Acta Biomater 2016; 32:149-160. [PMID: 26724503 DOI: 10.1016/j.actbio.2015.12.034] [Citation(s) in RCA: 139] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 12/15/2015] [Accepted: 12/23/2015] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Identification of a suitable treatment for osteochondral repair presents a major challenge due to existing limitations and an urgent clinical need remains for an off-the-shelf, low cost, one-step approach. A biomimetic approach, where the biomaterial itself encourages cellular infiltration from the underlying bone marrow and provides physical and chemical cues to direct these cells to regenerate the damaged tissue, provides a potential solution. To meet this need, a multi-layer collagen-based osteochondral defect repair scaffold has been developed in our group. AIM The objective of this study was to assess the in vivo response to this scaffold and determine its ability to direct regenerative responses in each layer in order to repair osteochondral tissue in a critical-sized defect in a rabbit knee. METHODS Multi-layer scaffolds, consisting of a bone layer composed of type I collagen (bovine source) and hydroxyapatite (HA), an intermediate layer composed of type I and type II collagen and HA; and a superficial layer composed of type I and type II collagen (porcine source) and hyaluronic acid (HyA), were implanted into critical size (3 × 5 mm) osteochondral defects created in the medial femoral condyle of the knee joint of New Zealand white rabbits and compared to an empty control group. Repair was assessed macroscopically, histologically and using micro-CT analysis at 12 weeks post implantation. RESULTS Analysis of repair tissue demonstrated an enhanced macroscopic appearance in the multi-layer scaffold group compared to the empty group. In addition, diffuse host cellular infiltration in the scaffold group resulted in tissue regeneration with a zonal organisation, with repair of the subchondral bone, formation of an overlying cartilaginous layer and evidence of an intermediate tidemark. CONCLUSION These results demonstrate the potential of this biomimetic multi-layered scaffold to support and guide the host reparative response in the treatment of osteochondral defects. STATEMENT OF SIGNIFICANCE Osteochondral defects, involving cartilage and the underlying subchondral bone, frequently occur in young active patients due to disease or injury. While some treatment options are available, success is limited and patients often eventually require joint replacement. To address this clinical need, a multi-layer collagen-based osteochondral defect repair scaffold designed to direct host-stem cell mediated tissue formation within each region, has been developed in our group. The present study investigates the in vivo response to this scaffold in a critical-sized defect in a rabbit knee. Results shows the scaffolds ability to guide the host reparative response leading to tissue regeneration with a zonal organisation, repair of the subchondral bone, formation of an overlying cartilaginous layer and evidence of an intermediate tidemark.
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Moran CJ, Ramesh A, Brama PAJ, O'Byrne JM, O'Brien FJ, Levingstone TJ. The benefits and limitations of animal models for translational research in cartilage repair. J Exp Orthop 2016; 3:1. [PMID: 26915001 PMCID: PMC4703594 DOI: 10.1186/s40634-015-0037-x] [Citation(s) in RCA: 115] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 12/28/2015] [Indexed: 12/31/2022] Open
Abstract
Much research is currently ongoing into new therapies for cartilage defect repair with new biomaterials frequently appearing which purport to have significant regenerative capacity. These biomaterials may be classified as medical devices, and as such must undergo rigorous testing before they are implanted in humans. A large part of this testing involves in vitro trials and biomechanical testing. However, in order to bridge the gap between the lab and the clinic, in vivo preclinical trials are required, and usually demanded by regulatory approval bodies. This review examines the in vivo models in current use for cartilage defect repair testing and the relevance of each in the context of generated results and applicability to bringing the device to clinical practice. Some of the preclinical models currently used include murine, leporine, ovine, caprine, porcine, canine, and equine models. Each of these has advantages and disadvantages in terms of animal husbandry, cartilage thickness, joint biomechanics and ethical and licencing issues. This review will examine the strengths and weaknesses of the various animal models currently in use in preclinical studies of cartilage repair.
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Affiliation(s)
- Conor J Moran
- Tissue Engineering Research Group, Department of Anatomy, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland.,Trinity Centre for Bioengineering, Trinity College Dublin, Dublin 2, Ireland.,Advanced Materials and Bioengineering Research (AMBER) Centre, RCSI & TCD, Dublin, Ireland
| | - Ashwanth Ramesh
- Tissue Engineering Research Group, Department of Anatomy, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland.,Trinity Centre for Bioengineering, Trinity College Dublin, Dublin 2, Ireland.,Advanced Materials and Bioengineering Research (AMBER) Centre, RCSI & TCD, Dublin, Ireland
| | - Pieter A J Brama
- Section of Veterinary Clinical Sciences, School of Veterinary Medicine, University College Dublin, Dublin, Ireland
| | - John M O'Byrne
- Tissue Engineering Research Group, Department of Anatomy, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland.,Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland
| | - Fergal J O'Brien
- Tissue Engineering Research Group, Department of Anatomy, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland.,Trinity Centre for Bioengineering, Trinity College Dublin, Dublin 2, Ireland.,Advanced Materials and Bioengineering Research (AMBER) Centre, RCSI & TCD, Dublin, Ireland
| | - Tanya J Levingstone
- Tissue Engineering Research Group, Department of Anatomy, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland. .,Trinity Centre for Bioengineering, Trinity College Dublin, Dublin 2, Ireland. .,Advanced Materials and Bioengineering Research (AMBER) Centre, RCSI & TCD, Dublin, Ireland.
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Li X, Ding J, Wang J, Zhuang X, Chen X. Biomimetic biphasic scaffolds for osteochondral defect repair. Regen Biomater 2015; 2:221-8. [PMID: 26816644 PMCID: PMC4669014 DOI: 10.1093/rb/rbv015] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 07/07/2015] [Indexed: 12/27/2022] Open
Abstract
The osteochondral defects caused by vigorous trauma or physical disease are difficult to be managed. Tissue engineering provides a possible option to regenerate the damaged osteochondral tissues. For osteochondral reconstruction, one intact scaffold should be considered to support the regeneration of both cartilage and subchondral bone. Therefore, the biphasic scaffolds with the mimic structures of osteochondral tissues have been developed to close this chasm. A variety of biomimetic bilayer scaffolds fabricated from natural or synthetic polymers, or the ones loading with growth factors, cells, or both of them make great progresses in osteochondral defect repair. In this review, the preparation and in vitro and/or in vivo verification of bioinspired biphasic scaffolds are summarized and discussed, as well as the prospect is predicted.
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Affiliation(s)
- Xuezhou Li
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, People's Republic of China;; Department of Orthopedics, The Second Hospital of Jilin University, Changchun 130041, People's Republic of China
| | - Jianxun Ding
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, People's Republic of China
| | - Jincheng Wang
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun 130041, People's Republic of China
| | - Xiuli Zhuang
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, People's Republic of China
| | - Xuesi Chen
- Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun 130022, People's Republic of China
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Hopper N, Wardale J, Brooks R, Power J, Rushton N, Henson F. Peripheral Blood Mononuclear Cells Enhance Cartilage Repair in in vivo Osteochondral Defect Model. PLoS One 2015; 10:e0133937. [PMID: 26252391 PMCID: PMC4529143 DOI: 10.1371/journal.pone.0133937] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 07/02/2015] [Indexed: 02/07/2023] Open
Abstract
This study characterized peripheral blood mononuclear cells (PBMC) in terms of their potential in cartilage repair and investigated their ability to improve the healing in a pre-clinical large animal model. Human PBMCs were isolated with gradient centrifugation and adherent PBMC’s were evaluated for their ability to differentiate into adipogenic, chondrogenic and osteogenic lineages and also for their expression of musculoskeletal genes. The phenotype of the PBMCs was evaluated using Stro-1, CD34, CD44, CD45, CD90, CD106, CD105, CD146 and CD166 cell surface markers. Osteochondral defects were created in the medial femoral condyle (MFC) of 24 Welsh mountain sheep and evaluated at a six month time point. Four cell treatment groups were evaluated in combination with collagen-GAG-scaffold: (1) MSC alone; (2) MSCs and PBMCs at a ratio of 20:1; (3) MSCs and PBMC at a ratio of 2:1 and (4) PBMCs alone. Samples from the surgical site were evaluated for mechanical properties, ICRS score and histological repair. Fresh PBMC samples were 90% positive for hematopoietic cell surface markers and negative for the MSC antibody panel (<1%, p = 0.006). However, the adherent PBMC population expressed mesenchymal stem cell markers in hypoxic culture and lacked CD34/45 positive cells (<0.2%). This finding demonstrated that the adherent cells had acquired an MSC-like phenotype and transformed in hypoxia from their original hematopoietic lineage. Four key genes in muskuloskeletal biology were significantly upregulated in adherent PBMCs by hypoxia: BMP2 4.2-fold (p = 0.0007), BMP6 10.7-fold (p = 0.0004), GDF5 2.0-fold (p = 0.002) and COL1 5.0-fold (p = 0.046). The monolayer multilineage analysis confirmed the trilineage mesenchymal potential of the adherent PBMCs. PBMC cell therapy was equally good as bone marrow MSC therapy for defects in the ovine large animal model. Our results show that PBMCs support cartilage healing and oxygen tension of the environment was found to have a key effect on the derivation of a novel adherent cell population with an MSC-like phenotype. This study presents a novel and easily attainable point-of-care cell therapy with PBMCs to treat osteochondral defects in the knee avoiding any cell manipulations outside the surgical room.
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Affiliation(s)
- Niina Hopper
- Division of Trauma and Orthopaedic Surgery, University of Cambridge, Addenbrooke's Hospital, Cambridge, BC2 0QQ, the United Kingdom
- * E-mail:
| | - John Wardale
- Division of Trauma and Orthopaedic Surgery, University of Cambridge, Addenbrooke's Hospital, Cambridge, BC2 0QQ, the United Kingdom
| | - Roger Brooks
- Division of Trauma and Orthopaedic Surgery, University of Cambridge, Addenbrooke's Hospital, Cambridge, BC2 0QQ, the United Kingdom
| | - Jonathan Power
- Department of Biological Sciences, University of Chester, Chester, CH1 4BJ, the United Kingdom
| | - Neil Rushton
- Division of Trauma and Orthopaedic Surgery, University of Cambridge, Addenbrooke's Hospital, Cambridge, BC2 0QQ, the United Kingdom
| | - Frances Henson
- Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, the United Kingdom
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Yan LP, Oliveira JM, Oliveira AL, Reis RL. Current Concepts and Challenges in Osteochondral Tissue Engineering and Regenerative Medicine. ACS Biomater Sci Eng 2015; 1:183-200. [DOI: 10.1021/ab500038y] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Le-Ping Yan
- 3B’s
Research Group−Biomaterials, Biodegradables and Biomimetics,
Headquarters of the European Institute of Excellence on Tissue Engineering
and Regenerative Medicine, University of Minho, AvePark, S. Cláudio
de Barco, 4806-909 Taipas, Guimarães, Portugal
- ICVS/3B’s−PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Joaquim M. Oliveira
- 3B’s
Research Group−Biomaterials, Biodegradables and Biomimetics,
Headquarters of the European Institute of Excellence on Tissue Engineering
and Regenerative Medicine, University of Minho, AvePark, S. Cláudio
de Barco, 4806-909 Taipas, Guimarães, Portugal
- ICVS/3B’s−PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Ana L. Oliveira
- 3B’s
Research Group−Biomaterials, Biodegradables and Biomimetics,
Headquarters of the European Institute of Excellence on Tissue Engineering
and Regenerative Medicine, University of Minho, AvePark, S. Cláudio
de Barco, 4806-909 Taipas, Guimarães, Portugal
- ICVS/3B’s−PT Government Associate Laboratory, Braga/Guimarães, Portugal
- CBQF−Center
for Biotechnology and Fine Chemistry, School of Biotechnology, Portuguese Catholic University, Porto 4200−072, Portugal
| | - Rui L. Reis
- 3B’s
Research Group−Biomaterials, Biodegradables and Biomimetics,
Headquarters of the European Institute of Excellence on Tissue Engineering
and Regenerative Medicine, University of Minho, AvePark, S. Cláudio
de Barco, 4806-909 Taipas, Guimarães, Portugal
- ICVS/3B’s−PT Government Associate Laboratory, Braga/Guimarães, Portugal
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Koushki N, Katbab AA, Tavassoli H, Jahanbakhsh A, Majidi M, Bonakdar S. A new injectable biphasic hydrogel based on partially hydrolyzed polyacrylamide and nanohydroxyapatite as scaffold for osteochondral regeneration. RSC Adv 2015. [DOI: 10.1039/c4ra10890f] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Fabrication of an injectable biphasic hydrogel based on partially hydrolyzed polyacrylamide (HPAM), nanocrystalline hydroxyapatite (nHAp), and chromium acetate (Cr(iii)) as a novel scaffold for osteochondral repair has been attempted.
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Affiliation(s)
- Newsha Koushki
- Polymer Engineering and Color Technology Department
- Amirkabir University of Technology
- Tehran
- Iran
- National Cell Bank of Iran
| | - Ali Asghar Katbab
- Polymer Engineering and Color Technology Department
- Amirkabir University of Technology
- Tehran
- Iran
| | | | | | - Mohammad Majidi
- National Cell Bank of Iran
- Pasteur Institute of Iran
- Tehran
- Iran
| | - Shahin Bonakdar
- National Cell Bank of Iran
- Pasteur Institute of Iran
- Tehran
- Iran
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Engineering complex orthopaedic tissues via strategic biomimicry. Ann Biomed Eng 2014; 43:697-717. [PMID: 25465616 DOI: 10.1007/s10439-014-1190-6] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 11/13/2014] [Indexed: 12/13/2022]
Abstract
The primary current challenge in regenerative engineering resides in the simultaneous formation of more than one type of tissue, as well as their functional assembly into complex tissues or organ systems. Tissue-tissue synchrony is especially important in the musculoskeletal system, wherein overall organ function is enabled by the seamless integration of bone with soft tissues such as ligament, tendon, or cartilage, as well as the integration of muscle with tendon. Therefore, in lieu of a traditional single-tissue system (e.g., bone, ligament), composite tissue scaffold designs for the regeneration of functional connective tissue units (e.g., bone-ligament-bone) are being actively investigated. Closely related is the effort to re-establish tissue-tissue interfaces, which is essential for joining these tissue building blocks and facilitating host integration. Much of the research at the forefront of the field has centered on bioinspired stratified or gradient scaffold designs which aim to recapitulate the structural and compositional inhomogeneity inherent across distinct tissue regions. As such, given the complexity of these musculoskeletal tissue units, the key question is how to identify the most relevant parameters for recapitulating the native structure-function relationships in the scaffold design. Therefore, the focus of this review, in addition to presenting the state-of-the-art in complex scaffold design, is to explore how strategic biomimicry can be applied in engineering tissue connectivity. The objective of strategic biomimicry is to avoid over-engineering by establishing what needs to be learned from nature and defining the essential matrix characteristics that must be reproduced in scaffold design. Application of this engineering strategy for the regeneration of the most common musculoskeletal tissue units (e.g., bone-ligament-bone, muscle-tendon-bone, cartilage-bone) will be discussed in this review. It is anticipated that these exciting efforts will enable integrative and functional repair of soft tissue injuries, and moreover, lay the foundation for the development of composite tissue systems and ultimately, total limb or joint regeneration.
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Getgood A, Henson F, Skelton C, Brooks R, Guehring H, Fortier LA, Rushton N. Osteochondral tissue engineering using a biphasic collagen/GAG scaffold containing rhFGF18 or BMP-7 in an ovine model. J Exp Orthop 2014; 1:13. [PMID: 26914758 PMCID: PMC4545804 DOI: 10.1186/s40634-014-0013-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 08/20/2014] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The aim of this study was to investigate the effect of combining rhFGF18 or BMP-7 with a biphasic collagen/GAG osteochondral scaffold (Chondromimetic) on the repair of osteochondral defects in sheep. METHODS Osteochondral defects (5.8x6mm) were created in the medial femoral condyle (MFC) and the lateral trochlea sulcus (LTS) of the stifle joint of 24 female sheep. Sheep were randomly assigned to four groups (n = 6); 1) empty defect, 2) scaffold only, 3) scaffold + rhFGF-18 (30 μg) and 4) scaffold + BMP-7 (100 μg). At 6 months the defects underwent non-destructive mechanical testing, gross assessment of repair tissue (ICRS score) and histological analysis (Modified O'Driscoll score). RESULTS ICRS repair score: Defects treated with scaffold + rhFGF18 (mean 9.83, 95% CI 8.43-11.23) and scaffold + BMP-7 (10, 9.06-10.94) in the MFC had significantly improved ICRS scores compared to empty defects (4.2, 0-8.80) (p = 0.002). Mechanical properties: BMP-7 treated defects (mean 64.35, 95% CI 56.88-71.82) were significantly less stiff than both the rhFGF18 (mean 84.1, 95% CI 76.8-91.4) and empty defects in the LTS, compared to both contralateral limb (p = 0.003), and the perilesional articular cartilage (p < 0.001). HISTOLOGY A statistically significant improvement in the modified O'Driscoll score was observed in the rhFGF18 treated group (mean 16.83, 95% CI 13.65-20.61) compared to the empty defects (mean 9, 95% CI 4.88-13.12) (p = 0.039) in the MFC. Excellent tissue fill, lateral integration and proteoglycan staining was observed. Only the rhFGF18 defects showed pericellular type VI collagen staining with positive type II collagen and reduced positive type I collagen staining. The majority of defects in the control and BMP-7 groups demonstrated fibrocartilagenous repair tissue. CONCLUSION Statistically significant improvements in gross repair, mechanical properties and histological score were found over empty defects when Chondromimetic was combined with rhFGF18. These results suggest that rhFGF18 may play a significant role in articular cartilage repair applications.
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Affiliation(s)
- Alan Getgood
- The Fowler Kennedy Sport Medicine Clinic 3M Centre, The University of Western Ontario, London, N6A 3K7, Ontario, Canada.
| | - Frances Henson
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.
| | - Carrie Skelton
- The University of Cambridge Orthopaedic Research Unit, Cambridge, UK.
| | - Roger Brooks
- The University of Cambridge Orthopaedic Research Unit, Cambridge, UK.
| | | | - Lisa A Fortier
- Department of Clinical Sciences, Cornell University, Ithaca, USA.
| | - Neil Rushton
- The University of Cambridge Orthopaedic Research Unit, Cambridge, UK.
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Li JJ, Kaplan DL, Zreiqat H. Scaffold-based regeneration of skeletal tissues to meet clinical challenges. J Mater Chem B 2014; 2:7272-7306. [PMID: 32261954 DOI: 10.1039/c4tb01073f] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The management and reconstruction of damaged or diseased skeletal tissues have remained a significant global healthcare challenge. The limited efficacy of conventional treatment strategies for large bone, cartilage and osteochondral defects has inspired the development of scaffold-based tissue engineering solutions, with the aim of achieving complete biological and functional restoration of the affected tissue in the presence of a supporting matrix. Nevertheless, significant regulatory hurdles have rendered the clinical translation of novel scaffold designs to be an inefficient process, mainly due to the difficulties of arriving at a simple, reproducible and effective solution that does not rely on the incorporation of cells and/or bioactive molecules. In the context of the current clinical situation and recent research advances, this review will discuss scaffold-based strategies for the regeneration of skeletal tissues, with focus on the contribution of bioactive ceramic scaffolds and silk fibroin, and combinations thereof, towards the development of clinically viable solutions.
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Affiliation(s)
- Jiao Jiao Li
- Biomaterials and Tissue Engineering Research Unit, School of AMME, University of Sydney, Sydney, NSW 2006, Australia.
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Pence JC, Gonnerman EA, Bailey RC, Harley BA. Strategies to balance covalent and non-covalent biomolecule attachment within collagen-GAG biomaterials. Biomater Sci 2014; 2:1296-1304. [PMID: 25147727 PMCID: PMC4136535 DOI: 10.1039/c4bm00193a] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Strategies to integrate instructive biomolecular signals into a biomaterial are becoming increasingly complex and bioinspired. While a large majority of reports still use repeated treatments with soluble factors, this approach can be prohibitively costly and difficult to translate in vivo for applications where spatial control over signal presentation is necessary. Recent efforts have explored the use of covalent immobilization of biomolecules to the biomaterial, via both bulk (ubiquitous) as well as spatially-selective light-based crosslinking, as a means to both enhance stability and bioactivity. However, little is known about how processing conditions during immobilization impact the degree of unintended non-covalent interactions, or fouling, that takes place between the biomaterial and the biomolecule of interest. Here we demonstrate the impact of processing conditions for bulk carbodiimide (EDC) and photolithography-based benzophenone (BP) crosslinking on specific attachment vs. fouling of a model protein (Concanavalin A, ConA) within collagen-glycosaminoglycan (CG) scaffolds. Collagen source significantly impacts the selectivity of biomolecule immobilization. EDC crosslinking intensity and ligand concentration significantly impacted selective immobilization. For benzophenone photoimmobilization we observed that increased UV exposure time leads to increased ConA immobilization. Immobilization efficiency for both EDC and BP strategies was maximal at physiological pH. Increasing ligand concentration during immobilization process led to enhanced immobilization for EDC chemistry, no impact on BP immobilization, but significant increases in non-specific fouling. Given recent efforts to covalently immobilize biomolecules to a biomaterial surface to enhance bioactivity, improved understanding of the impact of crosslinking conditions on selective attachment versus non-specific fouling will inform the design of instructive biomaterials for applications across tissue engineering.
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Affiliation(s)
- Jacquelyn C. Pence
- Dept. of Chemical and Biomolecular Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Emily A. Gonnerman
- Dept. of Chemical and Biomolecular Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Ryan C. Bailey
- Dept. of Chemistry, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Brendan A.C. Harley
- Dept. of Chemical and Biomolecular Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
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Gelber PE, Batista J, Millan-Billi A, Patthauer L, Vera S, Gomez-Masdeu M, Monllau JC. Magnetic resonance evaluation of TruFit® plugs for the treatment of osteochondral lesions of the knee shows the poor characteristics of the repair tissue. Knee 2014; 21:827-32. [PMID: 24856089 DOI: 10.1016/j.knee.2014.04.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Revised: 04/22/2014] [Accepted: 04/27/2014] [Indexed: 02/02/2023]
Abstract
BACKGROUND Treatment of osteochondral lesions of the knee with synthetic scaffolds seems to offer a good surgical option preventing donor site morbidity. The TruFit® plug has frequently been shown to not properly incorporate into. OBJECTIVE To evaluate the relationship between MRI findings and functional scores of patients with osteochondral lesions of the knee treated with TruFit®. METHODS Patients were evaluated with MOCART score for magnetic resonance imaging assessment of the repair tissue. KOOS, SF-36 and VAS were used for clinical evaluation. Correlation between size of the treated chondral defect and functional scores was also analyzed. RESULTS Fifty-seven patients with median follow-up of 44.8 months (range 24-73) were included. KOOS, SF-36 and VAS improved from a mean 58.5, 53.9 and 8.5 points to a mean 87.4, 86.6 and 1.2 at last follow-up (p<0.001). Larger lesions showed less improvement in KOOS (p=0.04) and SF-36 (p=0.029). Median Tegner values were restored to preinjury situation (5, range 2-10). Mean MOCART score was 43.2 ± 16.1. Although the cartilage layer had good integration, it showed high heterogeneity and no filling of the subchondral bone layer. CONCLUSIONS TruFit® failed to restore the normal MRI aspect of the subchondral bone and lamina in most cases. The appearance of the chondral layer in MRI was partially re-established. This unfavourable MRI appearance did not adversely influence the patient's outcome in the short time and they restored their previous level of activity. There was an inverse linear relationship between the size of the lesion and the functional scores. LEVEL OF EVIDENCE Therapeutic case series; level 4.
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Affiliation(s)
- Pablo Eduardo Gelber
- ICATME-Hospital Universitari Quirón-Dexeus, Universitat Autònoma de Barcelona, Sabino de Arana 5-19, 08028 Barcelona, Spain; Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Sant Quintí 89, 08041 Barcelona, Spain.
| | - Jorge Batista
- Centro Artroscópico Jorge Batista S.A., Pueyrredón 2446 5° B, C1119ACU Ciudad Autónoma de Buenos Aires, Argentina
| | - Angélica Millan-Billi
- Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Sant Quintí 89, 08041 Barcelona, Spain
| | - Luciano Patthauer
- Centro Artroscópico Jorge Batista S.A., Pueyrredón 2446 5° B, C1119ACU Ciudad Autónoma de Buenos Aires, Argentina
| | - Silvia Vera
- Centro Artroscópico Jorge Batista S.A., Pueyrredón 2446 5° B, C1119ACU Ciudad Autónoma de Buenos Aires, Argentina
| | - Mireia Gomez-Masdeu
- Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Sant Quintí 89, 08041 Barcelona, Spain
| | - Juan Carlos Monllau
- ICATME-Hospital Universitari Quirón-Dexeus, Universitat Autònoma de Barcelona, Sabino de Arana 5-19, 08028 Barcelona, Spain; Parc de Salut Mar, Universitat Autònoma de Barcelona, Passeig Marítim 25, 08003 Barcelona, Spain
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50
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Dorcemus DL, Nukavarapu SP. Novel and Unique Matrix Design for Osteochondral Tissue Engineering. ACTA ACUST UNITED AC 2014. [DOI: 10.1557/opl.2014.285] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
ABSTRACTOsteochondral (OC) tissue is comprised of articular cartilage, the subchondral bone and the central cartilage-bone interface. To facilitate proper regeneration, an equally complex and multiphasic matrix must be used. Although mono-phasic and bi-phasic matrices were previously applied, they failed to establish the OC interface upon regeneration. In this study, we designed and developed a novel matrix with increasing pore volume from one end to other, along the matrix length. For this matrix polylactide-co-glycolide (PLGA) 85:15 microspheres were combined with a water-soluble porogen in a layer-by-layer fashion and thermally sintered. The resulting matrix was then porogen-leached to form a gradiently-porous structured matrix. The formation of this gradient pore structure was established using Micro-Computed Tomography (μCT) scanning. A biodegradable hydrogel was infiltrated into the structure to form a unique OC matrix where the microsphere and hydrogel phases co-exist with opposing gradients. When the individual phases are associated with osteogenic and chondrogenic growth factors, the structureinduced factor delivery might provide the spatially controlled factor delivery necessary to regenerate osteochondral tissue structure. Overall, we designed a gradient matrix system that is expected to support osteochondral tissue engineering while forming a seamless interface between the cartilage and the bone matrix.
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