Department of Biomedical Sciences, Humanitas University, Milan, Italy; Humanitas Clinical and Research Center, Milan, Italy; First Moscow State Medical University Sechenov University, Bol'shaya Pirogovskaya Ulitsa, Moscow, Russia.
Department of Orthopedics, Hasharon Hospital, Rabin Medical Center, Petah Tikva, Israel.
Arthroscopy. 2020 Jul;36(7):1884-1894. doi: 10.1016/j.arthro.2020.02.026. Epub 2020 Feb 28.
To investigate the safety and regenerative potential of a hemicondylar aragonite-based scaffold in the reconstruction of large osteochondral lesions occupying an extensive portion of the medial femoral condyle in a goat model.
Eight Saanen goats were treated by the implantation of an aragonite-based scaffold (size: 19 × 8 × 8 mm) on a previously prepared hemicondylar osteochondral defect located in the right medial femoral condyle of the knee. Goats were euthanized after 12 months and the specimens underwent X-ray imaging, macroscopic, micro-computed tomography, histology, and immunohistochemistry evaluations to assess subchondral bone and cartilage regeneration.
In all 8 goats, no adverse event or persistent inflammation was observed. The evaluations performed showed integration of the scaffold, which almost completely resorbed at 12 months. In all animals, no signs of osteoarthritis progression were seen. Concurrent regeneration of the osteochondral unit was observed, with trabecular bone tissue replacing the implant and restoring the subchondral layer, and the formation of an overlying hyaline cartilage surface, well integrated within the surrounding native tissue, also was observed.
The use of the hemicondylar biphasic aragonite-based implant in the treatment of osteochondral defects in the goat model proved to be technically feasible and safe. The scaffold degraded and was replaced by regenerated tissue within the 12-month study period, restoring the osteochondral unit both at the level of the cartilaginous layer and the subchondral bone.
The present animal study describes a scaffold-based procedure for the treatment of large condylar defects, which often require massive allograft or unicompartmental replacement. The aragonite-based implant promoted a regeneration of both cartilage and subchondral bone, and its use as a "biologic" unicondylar prosthesis might be feasible also in the clinical setting.
研究半髁状碳酸化钙基支架在山羊模型中重建大面积占据股骨内侧髁广泛区域的骨软骨病变的安全性和再生潜力。
8 只萨能山羊通过在膝关节右股骨内侧髁预先准备好的骨软骨缺损处植入碳酸化钙基支架（大小：19×8×8mm）进行治疗。山羊在 12 个月后被安乐死，标本进行 X 线成像、宏观、微计算机断层扫描、组织学和免疫组织化学评估，以评估软骨下骨和软骨再生。
在所有 8 只山羊中，均未观察到不良事件或持续炎症。所有动物均未出现骨关节炎进展的迹象。同时观察到骨软骨单位的再生，小梁骨组织替代植入物并恢复软骨下层，形成覆盖的透明软骨表面，与周围天然组织很好地整合。
在山羊模型中，使用半髁状双相碳酸化钙基植入物治疗骨软骨缺损被证明在技术上是可行且安全的。在 12 个月的研究期间，支架降解并被再生组织取代，在软骨层和软骨下骨水平上恢复了骨软骨单位。
本动物研究描述了一种基于支架的治疗大面积髁状缺损的方法，这些缺损通常需要大量同种异体移植物或单髁置换。碳酸化钙基植入物促进了软骨和软骨下骨的再生，其作为“生物”单髁假体的使用在临床环境中也可能是可行的。
