Gregorio Marchiori1, Matteo Berni2, Marco Boi3, Giuseppe Filardo4. 1. IRCCS Istituto Ortopedico Rizzoli, Laboratory of Biomechanics and Technology Innovation, Via di Barbiano 1/10, 40136 Bologna, Italy. Electronic address: gregorio.marchiori@ior.it. 2. IRCCS Istituto Ortopedico Rizzoli, Laboratory of Biomechanics and Technology Innovation, Via di Barbiano 1/10, 40136 Bologna, Italy. 3. IRCCS Istituto Ortopedico Rizzoli, NanoBiotechnology Laboratory (NaBi), Via di Barbiano 1/10, 40136 Bologna, Italy. 4. IRCCS Istituto Ortopedico Rizzoli, NanoBiotechnology Laboratory (NaBi), Via di Barbiano 1/10, 40136 Bologna, Italy; IRCCS Istituto Ortopedico Rizzoli, Applied and Translational Research Center, Via di Barbiano 1/10, 40136 Bologna, Italy.
Abstract
BACKGROUND: Repair procedures and tissue engineering are solutions available in the clinical practice for the treatment of damaged articular cartilage. Regulatory bodies defined the requirements that any products, intended to regenerate cartilage, should have to be applied. In order to verify these requirements, the Food and Drug Administration (FDA, USA) and the International Standard Organization (ISO) indicated some Standard tests, which allow evaluating, in a reproducible way, the performances of scaffolds/treatments for cartilage tissue regeneration. METHODS: A review of the literature about cartilage mechanical characterization found 394 studies, from 1970 to date. They were classified by material (simulated/animal/human cartilage) and method (theoretical/applied; static/dynamic; standard/non-standard study), and analyzed by nation and year of publication. FINDINGS: While Standard methods for cartilage mechanical characterization still refer to studies developed in the eighties, expertise and interest on cartilage mechanics research are evolving continuously and internationally, with studies both in vitro - on human and animal tissues - and in silico, dealing with tissue function and modelling, using static and dynamic loading conditions. INTERPRETATION: there is a consensus on the importance of mechanical characterization that should be considered to evaluate cartilage treatments. Still, relative Standards need to be updated to describe advanced constructs and procedures for cartilage regeneration in a more exhaustive way. The use of the more complex, fibre-reinforced biphasic model, instead of the standard simple biphasic model, to describe cartilage response to loading, and the standardisation of dynamic tests can represent a first step in this direction.
BACKGROUND: Repair procedures and tissue engineering are solutions available in the clinical practice for the treatment of damaged articular cartilage. Regulatory bodies defined the requirements that any products, intended to regenerate cartilage, should have to be applied. In order to verify these requirements, the Food and Drug Administration (FDA, USA) and the International Standard Organization (ISO) indicated some Standard tests, which allow evaluating, in a reproducible way, the performances of scaffolds/treatments for cartilage tissue regeneration. METHODS: A review of the literature about cartilage mechanical characterization found 394 studies, from 1970 to date. They were classified by material (simulated/animal/humancartilage) and method (theoretical/applied; static/dynamic; standard/non-standard study), and analyzed by nation and year of publication. FINDINGS: While Standard methods for cartilage mechanical characterization still refer to studies developed in the eighties, expertise and interest on cartilage mechanics research are evolving continuously and internationally, with studies both in vitro - on human and animal tissues - and in silico, dealing with tissue function and modelling, using static and dynamic loading conditions. INTERPRETATION: there is a consensus on the importance of mechanical characterization that should be considered to evaluate cartilage treatments. Still, relative Standards need to be updated to describe advanced constructs and procedures for cartilage regeneration in a more exhaustive way. The use of the more complex, fibre-reinforced biphasic model, instead of the standard simple biphasic model, to describe cartilage response to loading, and the standardisation of dynamic tests can represent a first step in this direction.
Authors: Daniele Zuncheddu; Elena Della Bella; Andrea Schwab; Dalila Petta; Gaia Rocchitta; Silvia Generelli; Felix Kurth; Annapaola Parrilli; Sophie Verrier; Julietta V Rau; Marco Fosca; Margherita Maioli; Pier Andrea Serra; Mauro Alini; Heinz Redl; Sibylle Grad; Valentina Basoli Journal: Bone Res Date: 2021-10-27 Impact factor: 13.567