TruFit CB® bone plug: Chondral repair, scaffold design, surgical technique and early experiences

Expert Review of Medical Devices

Volumn 7, Issue 3, 2010, Pages 333-341

  Melton, Joel T K ^a   Wilson, Adrian J ^b   Chapman Sheath, Phillip ^c   Cossey, Andrew J ^a  

^a QUEEN ALEXANDRA HOSPITAL   (United Kingdom)

^b NORTH HAMPSHIRE HOSPITAL   (United Kingdom)

^c UNIVERSITY HOSPITAL SOUTHAMPTON NHS FOUNDATION TRUST   (United Kingdom)

Author keywords

Cartilage repair; Defect; Knee; Osteochondral; Scaffold; Surgery; TruFit CB

Indexed keywords

BIOMATERIAL; POLYGLACTIN; POLYMER; TISSUE SCAFFOLD;

ALLOGRAFT; AUTOLOGOUS CHONDROCYTE IMPLANTATION; BONE DISEASE; BONE PROSTHESIS; BONE REMODELING; CELL DIFFERENTIATION; CELL INFILTRATION; CHONDROPLASTY; HUMAN; HYDROPHILICITY; IMPLANTATION; MICROFRACTURE; NONHUMAN; NUCLEAR MAGNETIC RESONANCE IMAGING; ORTHOPEDIC SURGERY; OSTEOCHONDRAL DISEASE; OSTEOCHRONDAL IMPLANTATION; REVIEW; SUBCHONDRAL DRILLING; SURGICAL TECHNIQUE; TISSUE ENGINEERING; TISSUE REPAIR; ANIMAL; ARTICLE; CARTILAGE; CHEMISTRY; DRUG EFFECT; KNEE PROSTHESIS; PATHOLOGY; WOUND HEALING;

ANIMALS; BONE SUBSTITUTES; CARTILAGE; HUMANS; KNEE PROSTHESIS; MAGNETIC RESONANCE IMAGING; TISSUE ENGINEERING; TISSUE SCAFFOLDS; WOUND HEALING;

EID: 77951846825     PISSN: 17434440     EISSN: 17452422     Source Type: Journal    
DOI: 10.1586/erd.10.15     Document Type: Review

References (72)

1. Harman BD, Weeden SH, Lichota DK, Brindley GW. Osteochondral autograft transplantation in the porcine knee. Am. J. Sports Med. 34 (6), 913-918 (2006).
2. Hunter W. On the structure and diseases of articulating cartilages. Philos. Trans. Royal Soc. Lond. 42 B, 514-521 (1743).
3. Farmer JM, Martin DF, Boles CA, Curl W W. Chondral and osteochondral injuries. Diagnosis and management. Clin. Sports Med. 20 (2), 299-320 (2001).
4. Insall JN, Scott WN (Eds). Chapter 8 In: Surgery of the knee. 3rd Edition. Churchill Livingstone, Oxford, UK, 220 (2001).
5. Gleghorn JP, Banassar LJ. Lubrication mode analysis of articular cartilage using stribeck surfaces. J. Biomech. 41 (9), 1910-1918 (2008).
6. Ramachandran M. Basic Orthopaedic Sciences, The Stanmore Guide. Hodder Arnold, London, UK, 224-225 (2007).
7. Hills BA, Crawford RW. Normal and prosthetic synovial joints are lubricated by surface active phospholipids. J. Arthroplasty 18, 499-505 (2003).
8. Hills BA. Boundary lubrication in vivo. Proc. Inst. Mech. Eng. 214 (1), 83-94 (2000).
9. Dandy DJ. Abrasion chondroplasty. Arthroscopy 2 (1), 51-53 (1986).
10. Steadman JR, Rodkey WG, Rodrigo JJ. Microfracture: surgical technique and rehabilitation to treat chondral defects. Clin. Orthop. Rel. Res. 391, S362-S369 (2001).
11. Beiser IH, Kanat IO. Subchondral bone drilling: a treatment for cartilage defects. J. Foot Surg. 29 (6), 595-601 (1990).
12. Kelbérine F, Frank A. Arthroscopic treatment of osteochondral lesions of the talar dome: a retrospective study of 48 cases. Arthroscopy 15 (1), 77-84 (1999). (Pubitemid 29031779)
13. Bartlett W, Skinner JA, Gooding CR et al. Autologous chondrocyte implantation versus matrix-induced autologous chondrocyte implantation for osteochondral defects of the knee: a prospective, randomised study. J. Bone Joint Surg. Br. 87, 640-645 (2005). (Pubitemid 40711636)
14. Attmanspacher W, Dittrich V, Stedfeld HW. [Experiences with arthroscopic therapy of chondral and osteochondral defects of the knee joint with OATS (Osteochondral Autograft Transfer System)]. Zentralbl. Chir. 125 (6), 494-499 (2000).
15. Pritzker K P, Gross AE, Langer F, Luk SC, Houpt JB. Articular cartilage transplantation. Hum. Pathol. 8 (6), 635-651 (1977). (Pubitemid 8235753)
16. Magnussen RA, Dunn WR, Carey JL, Spindler KP. Treatment of focal articular cartilage defects in the knee: a systematic review. Clin. Orthop. Rel. Res. 466 (4), 952-962 (2008).
17. Friedman MJ, Berasi CC, Fox JM, Del Pizzo W, Snyder SJ, Ferkel RD. Preliminary results with abrasion arthroplasty in the osteoarthritic knee. Clin. Orthop. Relat. Res. 182, 200-205 (1984). (Pubitemid 14182861)
18. Akizuki S, Yasukawa Y, Takizawa T. Does arthroscopic abrasion arthroplasty promote cartilage regeneration in osteoarthritic knees with eburnation? A prospective study of high tibial osteotomy with abrasion arthroplasty versus high tibial osteotomy alone. Arthroscopy 13, 9-17 (1997). (Pubitemid 27078861)
19. Pridie KH. A method of resurfacing osteoarthritic knee joints. J. Bone Joint Surg. Br. 41 (3), 618-619 (1959).
20. Vachon A, Bramlage LR, Gabel AA, Weisbrode S. Evaluation of the repair process of cartilage defects of the equine third carpal bone with and without subchondral bone perforation. Am. J. Vet. Res. 47 (12), 2637-2645 (1986).
21. Chen H, Sun J, Hoemann CD et al. Drilling and microfracture lead to different bone structure and necrosis during bone-marrow stimulation for cartilage repair. J. Orthop. Res. 27 (11), 1432-1438 (2009).
22. Steadman JR, Rodkey WG, Singleton SB, Briggs KK. Microfracture technique for full thickness chondral defects: technique and clinical results. Operative Tech. Orth. 7, 300-305 (1997).
23. Mithoefer K, Williams RJ, Warren RF et al. The microfracture technique for the treatment of articular cartilage lesions in the knee. A prospective cohort study. J. Bone Joint Surg. Am. 87, 1911-1920 (2005). (Pubitemid 41279120)
24. Williams RJ, Harmly HW. Microfracture: indications, technique and results. Instr. Course Lect. 56, 419-428 (2007).
25. Carranza-Bencano A, Perez-Tinao M, Ballesteros-Vasquez P et al. Comparative study of the reconstruction of articular cartilage defects with free costal perichondrial grafts and free tibial periostial grafts: an experimental study on rabbits. Calcif. Tissues Int. 65, 402-407 (1999). (Pubitemid 29514080)
26. Peterson L, Menche D, Grande D et al. Chondrocyte transplantation - an experimental model in the rabbit. Trans. Orthop. Res. Soc. 9, 218 (1984).
27. Peterson L, Minas T, Brittberg M et al. Two to 9-year outcome after autologous chondrocyte transplantation of the knee. Clin. Orthop. Relat. Res. 374, 212-234 (2000). (Pubitemid 30263488)
28. Bentley G, Biant LC, Carrington RW et al. A prospective randomised comparison of autologous chondrocyte transplantation and mosaicplasty for osteochondral defects in the knee. J. Bone Joint Surg. Br. 85, 223-230 (2003). (Pubitemid 36410545)
29. Brittberg M, Lindahl A, Nilson A et al. Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation. N. Eng. J. Med. 331, 889-895 (1994). (Pubitemid 24299869)
30. Knutsen G, Drogset JO, Engebretsen L et al. A randomized trial comparing autologous chondrocyte implantation with microfracture. Findings at fve years. J. Bone Joint Surg. Am. 89 (10), 2105-2112 (2007). (Pubitemid 47606154)
31. Beris AE, Lykissas MG, Papageorgiou CD, Georgeoulis AD. Advances in articular cartilage repair. Injury 36 (Suppl.) S14-S23 (2005). • Thorough review of techniques currently used in cartilage repair surgery.
32. Saris DB, Vanlauwe J, Victor J et al. Characterized chondrocyte implantation results in better structural repair when treating symptomatic cartilage defects of the knee in a randomized controlled trial versus microfracture. Am. J. Sports Med. 36 (2), 235-246 (2008).
33. Bachmann G, Basad E, Lommel D, Steinmeyer J. [MRI in the follow-up of matrix-supported autologous chondrocyte transplantation (MACI) and microfracture]. Radiologe 44, 773-782 (2004).
34. Erggelet C, Sittinger M, Lahm A. The arthroscopic implantation of autologous chondrocytes for the treatment of full-thickness cartilage defects of the knee joint. Arthroscopy 19 (1), 108-110 (2003). (Pubitemid 36330150)
35. Kirker-Head CA, Van Sickle DC, Ek SW, McCool JC. Safety of and biological and functional response to a novel met al.lic implant for the management of focal full-thickness cartilage defects: preliminary assessment in an animal model out to 1 year. J. Orthop. Res. 24 (5), 1096-1108 (2006).
36. Custers RJH, Creemers LB, Van Rijen MH, Verbout AJ, Saris DBF, Dhert WJA. Cartilage damage caused by met al. implants applied for the treatment of established localized cartilage defects in a rabbit model. J. Orthop. Res. 27 (1), 84-90 (2009).
37. Bobic V, Morgan C, Carter T. Osteochondral autologous graft transfer. Op. Tech. Sports Med. 8, 168-178 (2000).
38. Huntley JS, Bush PG, McBurnie JM et al. Chondrocyte death associated with human femoral osteochondral harvest as performed for mosaicplasty. J. Bone Joint Surg. Am. 87, 351-360 (2005).
39. LaPrade RF, Botker J, Herzog M, Agel J. Refrigerated osteoarticular allografts to treat articular cartilage defects of the femoral condyles. A prospective outcomes study. J. Bone Joint Surg. Am. 91 (4), 805-811 (2009).
40. Williams RJ, Ranawat AS, Potter HG, Carter T, Warren RF. Fresh stored allografts for the treatment of osteochondral defects of the knee. J. Bone Joint Surg. Am. 89 (4), 718-726 (2007). (Pubitemid 46564274)
41. McCulloch PC, Kang RW, Sobhy MH, Hayden JK, Cole BJ. Prospective evaluation of prolongued fresh allograft transplantation of the femoral condyle: minimum 2-year follow up. Am. J. Sports Med. 35 (3), 411-420 (2007).
42. Gross AE, Kim W, Las Heras F, Backstein D, Safr O, Pritzker K P. Fresh osteochondral allografts for posttraumatic knee defects: long-term followup. Clin. Orthop. Relat. Res. 466 (8), 1863-1870 (2008).
43. Glenn RE, McCarty EC, Potter HG, Juliao SF, Gordon JD, Spindler K P. Comparison of fresh osteochondral autografts and allografts: a canine model. Am. J. Sports Med. 34 (7), 1084-1093 (2006).
44. Caldwell PE, Shelton WR. Indications for allografts. Orthop. Clin. North Am. 36 (4), 459-467 (2005).
45. Wakitani S, Goto T, Young RG, Mansour JM, Goldberg VM, Caplan AI. Repair of large full-thickness articular cartilage defects with allograft articular chondrocytes embedded in a collagen gel. Tissue Eng. 4 (4), 429-444 (1998). (Pubitemid 28553529)
46. She Z, Liu W, Feng Q. Self assembly model, hepatocytes attachment and infammatory response for silk fbroin/chitosan scaffolds. Biomed. Mater. 4 (4), 45014 (2009).
47. Canton I, Mckean R, Charnley M et al. Development of an ibuprofen releasing biodegradable PLA/PGA electrospun scaffold for tissue regeneration. Biotechnol. Bioeng. 105, 396-408 (2010).
48. Raghunath J, Rollo J, Sales KM, Butler PE, Seilafan AM. Biomaterials and scaffold design; key to tissue-engineering cartilage. Biotechnol. App. Biochem. 46 (2), 73-84 (2007). • Review of the material properties required of scaffolds for successful cartilage regeneration. (Pubitemid 46271789)
49. Jansen EJ, Pieper J, Gijbels MJ et al. PEOT/PBT based scaffolds with low mechanical properties improve cartilage repair tissue formation in osteochondral defects. J. Biomed. Mater. Res. A 89 (2), 444-452 (2009).
50. Jansen EJ, Sladek RE, Bahar H et al. Hydrophobicity as a design criterion for polymer scaffolds in bone tissue engineering. Biomaterials 26 (21), 4423-4431 (2005). (Pubitemid 40208603)
51. Woodfeld TB, Malda J, De Wijn J, Peters F, Riesle J, Van Blitterswijk CA. Design of porous scaffolds for cartilage tissue engineering using a threedimensional fber deposition technique. Biomaterials 25 (18), 4149-4161 (2004). (Pubitemid 38388579)
52. Lien SM, Ko LY, Huang TJ. Effect of pore size on ECM secretion and cell growth in gelatin scaffold for articular cartilage tissue engineering. Acta Biomater. 5 (2), 670-679 (2009).
53. Nagura I, Fujioka H, Kokubu T, Makino T, Sumi Y, Kurosaka M. Repair of osteochondral defects with a new porous synthetic polymer scaffold. J. Bone Joint Surg. Br. 89 (2), 258-264 (2007). (Pubitemid 46421480)
54. Holland TA, Bodde EW, Baggett LS, Tabata Y, Mikos AG, Jansen JA. Osteochondral repair in the rabbit model utilizing bilayered, degradable oligo (poly (ethylene glycol) fumarate) hydrogel scaffolds. J. Biomed. Mater. Res. 75 (1), 156-167 (2005). (Pubitemid 41298197)
55. Sherwood JK, Riley SL, Palazzollo R et al. A three dimensional ostechondral composite scaffold for articular cartilage repair. Biomaterials 23 (24), 4739-4751 (2002).
56. Chu CR, Coutts RD, Yoshioka M, Harwood FL, Monosov AZ, Amiel D. Articular cartilage repair using allogenic perichondrocyte-seeded biodegradable porous polylactic acid (PLA) : a tissueengineering study. J. Biomed. Mater. Res. 29 (9), 1147-1154 (1995).
57. Swieszkowski W, Tuan BH, Kurzydlowski KJ, Hutmacher DW. Repair and regeneration of osteochondral defects in the articular joints. Biomol. Eng 24 (5), 489-495 (2007). (Pubitemid 350123179)
58. Mardones RM, Reinholz GG, Fitzsimmons JS et al. Development of a biologic prosthetic composite for cartilage repair. sTissue Eng. 11 (9-10), 1368-1378 (2005).
59. Caranza-Bencano A, Armas-Padron JR, Gili-Miner M, Lozano MA. Carbon fber implants in osteochondral defects of the rabbit patella. Biomaterials 21 (21), 2171-2176 (2000). (Pubitemid 30612388)
60. Pulkkinen H, Tiitu V, Lammentausta E et al. Cellulose sponge as a scaffold for cartilage tissue engineering. Biomed. Mater. Eng. 16 (4 Suppl.), S29-S35 (2006). (Pubitemid 43953674)
61. Nehrer S, Dorotka R, Domayer S. Treatment of full-thickness chondral defects with hyalograft C in the knee: a prospective clinical case series with 2 to 7 years' follow-up. Am. J. Sports Med. 37 (Suppl. 1), S81-S87 (2009).
62. Yang Q, Peng J, Guo Q et al. A cartilage ECM-derived 3-D porous acellular matrix scaffold for in vivo cartilage tissue engineering with PKH26-labeled chondrogenic bone marrow-derived mesenchymal stem cells. Biomaterials 29 (5), 2378-2387 (2008).
63. Gellynck K, Verdonk PC, Van Nimmen E et al. Silkworm and spider silk scaffolds for chondrocyte support. J. Mater. Sci. Mater. Med. 19 (11), 3399-3409 (2008).
64. Chajra H, Rousseau CF, Cortial D et al. Collagen-based biomaterials and cartilage engineering. Application to osteochondral defects. Biomed. Mater. Eng. 18 (Suppl. 1), S33-S45 (2008). (Pubitemid 351366860)
65. Wakitani S, Goto T, Young RG, Mansour JM, Goldberg VM, Caplan AI. Repair of large full-thickness articular cartilage defects with allograft articular chondrocytes embedded in a collagen gel. Tissue Eng. 4 (4), 429-444 (1998). • Use of allograft chondrocytes within collagen scaffold using a rabbit model in this study led to biomechanically and histologically superior neocartilaginous tissue in this study. (Pubitemid 28553529)
66. Lohmann CH, Schwartz Z, Niederauer GG, Carnes DL, Dean DD, Bayan BD. Pretreatment with platelet derived growth factor-BB modulates the ability of costochondral resting zone chondrocytes incorporated into PLA/PGA scaffolds to form new cartilage in vivo. Biomaterials 21 (1), 49-61 (2000). • Currently much interest is focused on 'seeding' of scaffolds with cellular components and biologically active factors to improve chondral tissue differentiation within implanted scaffolds.
67. Tamai N, Myoui A, Hirao M et al. A new biotechnology for articular cartilage repair: subchondral implantation of a composite of interconnected porous hydroxyapatite, synthetic polymer (PLA-PEG), and bone morphogenetic protein-2 (rhBMP-2). Osteoarthr. Cartil. 13 (5), 405-417 (2005). (Pubitemid 40631286)
68. Uematsu K, Hattori K, Ishimoto Y et al. Cartilage regeneration using mesenchymal stem cells and a three-dimensional poly-lactic-glycolic acid (PLGA) scaffold. sBiomaterials 26 (20), 4273-4279 (2005). (Pubitemid 40430855)
69. Huang X, Yang D, Yan W et al. Osteochondral repair using the combination of fbroblast growth factor and amorphous calcium phosphate/poly (l-lactic acid) hybrid materials. Biomaterials 28 (20), 3091-3100 (2007). (Pubitemid 46602517)
70. ® implant in a goat model, and reference to the early clinical results in patients in the Hospital for Special Surgery Cartilage Registry, HSS, NY, USA.
71. Saithna A, Dunne K, Kuchenbecker T, Thompson P, Dhillon M, Spalding T. Qualitative MRI related to clinical results following cartilage repair using TruFit plugs: a two year follow up study. Presented at: British Association for Surgery of the Knee Meeting. Edinburgh, UK, 2 April y2009. •• Correlation of clinical scores to qualitative MRI fndings in 26 sporting patients in whom TruFit CB implants had been inserted, showing that incorporation on scan and clinical results continue to improve in the frst 2 years.
72. Carmont MR, Carey-Smith R, Saithna A, Dhillon M, Thompson P, Spalding T Delayed incorporation of a TruFit plug: perseverance is recommended. Arthroscopy 25 (7), 810-814 (2009). • Perseverance for up to 2 years can be required to see improving clinical results and better incorporation of TruFit CB implants.