Objective:The aim of this study was to evaluate the regenerative potential of cell-laden and cell-free collagen matrices in comparison to microfracture treatment applied to full-thickness chondral defects in an ovine model.Methods:Animals (n = 30) were randomized into 5 treatment groups, and 7-mm full-cartilage-thickness defects were set at the trochlea and medial condyle of both knee joints and treated as follows: 2 scaffolds in comparison (collagen I/III, Chondro-Gide®; collagen II, Chondrocell®) for covering microfractured defects (autologous matrix-induced chondrogenesis), both scaffolds colonized in vitro with autologous chondrocytes (matrix-associated chondrocyte transplantation), or scaffold-free microfracture technique. One year after surgery, cartilage lesions were biomechanically (indentation test), histologically (O’Driscoll score), and immunohistochemically (collagen type I and II staining) evaluated.Results:All treatment groups of the animal model induced more repair tissue and showed better histological scores and biomechanical properties compared to controls. The average thickness of the repair tissue was significantly greater when a scaffold was used, especially the collagen I/III membrane. However, none of the index procedures surpassed the others from a biomechanical point of view or based on the histological scoring. Collagen type II expression was better in condylar defects compared to the trochlea, especially in those treated with collagen I/III membranes.Conclusion:Covering of defects with suitable matrices promotes repair tissue formation and is suggested to be a promising treatment option for cartilage defects. However, it failed to improve the biomechanical and histological properties of regenerated articular cartilage compared to microfracture alone in an ovine model under the given circumstances.
Mechanical testing of articular cartilage and repair tissue enables judgment of their capacity in withstanding mechanical loading. In the past, different methods have been developed requiring a complex technical setup and extensive data analysis. Therefore, the aim of the present project was to build up a simple measuring apparatus for laboratory indentation tests. The device consists of an incremental optical displacement transducer with a sleeve bearing guided plunger and a spherical tip made of polished steel (radius: 0.75 or 1.5 mm), a sensitive load cell and a stiff frame. The indentation force results from the plunger's gravity plus the force of the spring inside the displacement transducer and levels at 0.170 N or 0.765 N. The displacement transducer is fixed to the frame via the load cell that enables one to detect the initial contact of the tip with the tissue. The load cell has a standard uncertainty of 2 mN and the displacement transducer of 1 microm. From indentation-creep tests, a "0.25-s elastic modulus" is calculated. Measurements on thin rubber sheets were carried out to determine the quality of the measuring device. Compression tests on cylinders made of these rubber sheets yielded control data, and a good agreement with the "0.25-s elastic modulus" was found. Indentation tests on cartilage at different sites of sheep femoral condyles yielded a very good repeatability of the measurement results (+/-7.5%).
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