Fixation of Hydrogel Constructs for Cartilage Repair in the Equine Model: A Challenging Issue
Mancini, Irina A.D.; Vindas Bolaños, Rafael A.; Brommer, Harold; Castilho, Miguel; Ribeiro, Alexandro; Van Loon, Johannes P.A.M.; Mensinga, Anneloes; Van Rijen, Mattie H.P.; Malda, Jos; van Weeren, P. René
(2017) Tissue engineering. Part C, Methods, volume 23, issue 11, pp. 804 - 814
(Article)
Abstract
Objective: To report on the experiences with the use of commercial and autologous fibrin glue (AFG) and of an alternative method based on a 3D-printed polycaprolactone (PCL) anchor for the fixation of hydrogel-based scaffolds in an equine model for cartilage repair. Methods: In a first study, three different hydrogel-based materials
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were orthotopically implanted in nine horses for 1-4 weeks in 6 mm diameter full-thickness cartilage defects in the medial femoral trochlear ridge and fixated with commercially available fibrin glue (CFG). One defect was filled with CFG only as a control. In a second study, CFG and AFG were compared in an ectopic equine model. The third study compared the efficacy of AFG and a 3D-printed PCL-based osteal anchor for fixation of PCL-reinforced hydrogels in three horses for 2 weeks, with a 4-week follow-up to evaluate integration of bone with the PCL anchor. Short-term scaffold integration and cell infiltration were evaluated by microcomputed tomography and histology as outcome parameters. Results: The first study showed signs of subchondral bone resorption in all defects, including the controls filled with CFG only, with significant infiltration of neutrophils. Ectopically, CFG induced clear inflammation with strong neutrophil accumulation; AFG was less reactive, showing fibroblast infiltration only. In the third study the fixation potential for PCL-reinforced hydrogels of AFG was inferior to the PCL anchor. PCL reinforcement had disappeared from two defects and showed signs of dislodging in the remaining four. All six constructs fixated with the PCL anchor were still in place after 2 weeks. At 4 weeks, the PCL anchor showed good integration and signs of new bone formation. Conclusions: The use of AFG should be preferred to xenogeneic products in the horse, but AFG is subject to individual variations and laborious to make. The PCL anchor provides the best fixation; however, this technique involves the whole osteochondral unit, which entails a different conceptual approach to cartilage repair.
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Keywords: cartilage repair, equine model, fibrin glue, fixation, hydrogels, osteochondral and chondral scaffolds, Bioengineering, Medicine (miscellaneous), Biomedical Engineering
ISSN: 1937-3384
Publisher: Mary Ann Liebert Inc.
Note: Funding Information: The authors thank C. Wayne McIlwraith, BVSc, PhD Dipl ACVS/ECVS/ACVSMR for his much appreciated help and constructive comments and A. Bouwman for the help in data collection of study 1. The research leading to these results has received funding from the Ministerio de Ciencia, Tecnología y Telecomunicaciones de Costa Rica (MICITT), the Consejo Nacional para Investigaciones Científicas y Tecnológicas de Costa Rica (CONICIT), the European Community’s Seventh Framework Programme (FP7/2007– 2013) under grant agreement 309962 (HydroZONES), the European Research Council under grant agreement 647426 (3D-JOINT), and the Dutch Arthritis Foundation (LLP-12 and LLP-22). Publisher Copyright: © Copyright 2017, Mary Ann Liebert, Inc. 2017.
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