Yucekul Altug, Ozdil Deniz, Kutlu Nuri Hunkar, Erdemli Esra, Aydin Halil Murat, Doral Mahmut Nedim
Department of Orthopedics and Traumatology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
BMT Calsis Health Technologies Co., Ankara, Turkey.
J Tissue Eng. 2017 Apr 13;8:2041731417697500. doi: 10.1177/2041731417697500. eCollection 2017 Jan-Dec.
Cartilage defects are a source of pain, immobility, and reduced quality of life for patients who have acquired these defects through injury, wear, or disease. The avascular nature of cartilage tissue adds to the complexity of cartilage tissue repair or regeneration efforts. The known limitations of using autografts, allografts, or xenografts further add to this complexity. Autologous chondrocyte implantation or matrix-assisted chondrocyte implantation techniques attempt to introduce cultured cartilage cells to defect areas in the patient, but clinical success with these are impeded by the avascularity of cartilage tissue. Biodegradable, synthetic scaffolds capable of supporting local cells and overcoming the issue of poor vascularization would bypass the issues of current cartilage treatment options. In this study, we propose a biodegradable, tri-layered (poly(glycolic acid) mesh/poly(l-lactic acid)-colorant tidemark layer/collagen Type I and ceramic microparticle-coated poly(l-lactic acid)-poly(ϵ-caprolactone) monolith) osteochondral plug indicated for the repair of cartilage defects. The porous plug allows the continual transport of bone marrow constituents from the subchondral layer to the cartilage defect site for a more effective repair of the area. Assessment of the in vivo performance of the implant was conducted in an ovine model (n = 13). In addition to a control group (no implant), one group received the implant alone (Group A), while another group was supplemented with hyaluronic acid (0.8 mL at 10 mg/mL solution; Group B). Analyses performed on specimens from the in vivo study revealed that the implant achieves cartilage formation within 6 months. No adverse tissue reactions or other complications were reported. Our findings indicate that the porous biocompatible implant seems to be a promising treatment option for the cartilage repair.
软骨缺损会给因受伤、磨损或疾病而出现这些缺损的患者带来疼痛、行动不便和生活质量下降等问题。软骨组织的无血管特性增加了软骨组织修复或再生的复杂性。使用自体移植物、同种异体移植物或异种移植物的已知局限性进一步加剧了这种复杂性。自体软骨细胞植入或基质辅助软骨细胞植入技术试图将培养的软骨细胞引入患者的缺损区域,但由于软骨组织的无血管性,这些技术在临床上的成功率受到阻碍。能够支持局部细胞并克服血管化不良问题的可生物降解合成支架将绕过当前软骨治疗方案的问题。在本研究中,我们提出了一种用于修复软骨缺损的可生物降解三层(聚乙醇酸网/聚左旋乳酸-着色潮标层/Ⅰ型胶原蛋白和陶瓷微粒涂层的聚左旋乳酸-聚己内酯整体)骨软骨塞。多孔塞允许骨髓成分从软骨下层持续运输到软骨缺损部位,以便更有效地修复该区域。在绵羊模型(n = 13)中对植入物的体内性能进行了评估。除了对照组(无植入物)外,一组仅接受植入物(A组),而另一组补充透明质酸(10 mg/mL溶液0.8 mL;B组)。对体内研究标本进行的分析表明,植入物在6个月内实现了软骨形成。未报告不良组织反应或其他并发症。我们的研究结果表明,这种多孔生物相容性植入物似乎是一种有前景的软骨修复治疗选择。