Hanna Schell1, Elisabeth Zimpfer1, Katharina Schmidt-Bleek2,3, Tobias Jung4, Georg N Duda1,5, Leif Ryd6. 1. Julius Wolff Institut, Charité-Universitätsmedizin Berlin, Berlin, Germany. 2. Julius Wolff Institut, Charité-Universitätsmedizin Berlin, Berlin, Germany. katharina.schmidt-bleek@charite.de. 3. Berlin Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Berlin, Germany. katharina.schmidt-bleek@charite.de. 4. Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany. 5. Berlin Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Berlin, Germany. 6. Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institute, Stockholm, Sweden.
Abstract
PURPOSE: The treatment of osteochondral defects in joint cartilage remains challenging due to its limited repair capacity. This study presents a metallic osteochondral plug with hydroxyapatite (HA)-coated cap edges for improved implant-tissue contact. The hypothesis was that improved attachment prevents from synovial fluid-influx and thereby avoids osteolysis and resulting implant instability. METHODS: In total, 24 female, adult sheep were randomized into three groups. All animals received an Episealer®-implant in the medial condyle of the right knee. The implants were coated with two different HA versions or uncoated (control group). After 12 weeks, the implant-tissue connections were analysed radiologically and histologically. RESULTS: In general, the groups with the coated cap edges showed a better quality of tissue connection to the implant. The occurrence of gaps between tissue and implant was more seldom, the binding of calcified and hyaline cartilage to the cap was significantly better than in the uncoated group. A histomorphometrically measured lower amount of void space in these groups compared to the group with the uncoated edges confirmed that. CONCLUSIONS: The hypothesis of a tighter cartilage bone contact was confirmed. The HA coating of the implant's cap edges resulted in better adherence of cartilage to the implant, which was not previously reported. In conclusion, this led to a better contact between implant and cartilage as well as neighbouring bone. In clinical routine, joint fluid is aggressive, penetrates through cartilage rifts, and promotes osteolysis and loosening of implants. The observed sealing effect will act to prevent joint fluid to get access to the implant-tissue interfaces. Joint fluid is aggressive, can cause osteolysis, and can, clinically cause pain. These effects are liable to decrease with these findings and will further the longevity of these osteochondral implants.
PURPOSE: The treatment of osteochondral defects in joint cartilage remains challenging due to its limited repair capacity. This study presents a metallic osteochondral plug with hydroxyapatite (HA)-coated cap edges for improved implant-tissue contact. The hypothesis was that improved attachment prevents from synovial fluid-influx and thereby avoids osteolysis and resulting implant instability. METHODS: In total, 24 female, adult sheep were randomized into three groups. All animals received an Episealer®-implant in the medial condyle of the right knee. The implants were coated with two different HA versions or uncoated (control group). After 12 weeks, the implant-tissue connections were analysed radiologically and histologically. RESULTS: In general, the groups with the coated cap edges showed a better quality of tissue connection to the implant. The occurrence of gaps between tissue and implant was more seldom, the binding of calcified and hyaline cartilage to the cap was significantly better than in the uncoated group. A histomorphometrically measured lower amount of void space in these groups compared to the group with the uncoated edges confirmed that. CONCLUSIONS: The hypothesis of a tighter cartilage bone contact was confirmed. The HA coating of the implant's cap edges resulted in better adherence of cartilage to the implant, which was not previously reported. In conclusion, this led to a better contact between implant and cartilage as well as neighbouring bone. In clinical routine, joint fluid is aggressive, penetrates through cartilage rifts, and promotes osteolysis and loosening of implants. The observed sealing effect will act to prevent joint fluid to get access to the implant-tissue interfaces. Joint fluid is aggressive, can cause osteolysis, and can, clinically cause pain. These effects are liable to decrease with these findings and will further the longevity of these osteochondral implants.
Authors: László Hangody; Jozsef Dobos; Eszter Baló; Gergely Pánics; Laszlo Rudolf Hangody; Istvan Berkes Journal: Am J Sports Med Date: 2010-04-01 Impact factor: 6.202
Authors: N Martinez-Carranza; L Ryd; K Hultenby; H Hedlund; H Nurmi-Sandh; A S Lagerstedt; P Schupbach; H E Berg Journal: Osteoarthritis Cartilage Date: 2015-09-25 Impact factor: 6.576
Authors: Gwendolyn Vuurberg; Mikel L Reilingh; Christiaan J A van Bergen; Inge C M van Eekeren; Rogier M Gerards; C Niek van Dijk Journal: Am J Sports Med Date: 2018-04-06 Impact factor: 6.202
Authors: Pablo E Gelber; Simone Perelli; Maximiliano Ibañez; Eduard Ramírez-Bermejo; Oscar Fariñas; Juan C Monllau; Vicente Sanchis-Alfonso Journal: Arthrosc Tech Date: 2018-05-14
Authors: Nicolas Martinez-Carranza; Peter Rockborn; David Roberts; Magnus Högström; Anders Stålman Journal: Cartilage Date: 2020-10-27 Impact factor: 3.117
Authors: Johannes Holz; Tim Spalding; Tarek Boutefnouchet; Pieter Emans; Karl Eriksson; Mats Brittberg; Lars Konradsen; Clemens Kösters; Peter Verdonk; Magnus Högström; Martin Lind Journal: Knee Surg Sports Traumatol Arthrosc Date: 2020-10-06 Impact factor: 4.114