title: Development of artificial articular cartilage.
abstract: Attempts have been made to develop an artificial articular cartilage on the basis of a new viewpoint of joint biomechanics in which the lubrication and load-bearing mechanisms of natural and artificial joints are compared. Polyvinyl alcohol hydrogel (PVA-H), 'a rubber-like gel', was investigated as an artificial articular cartilage and the mechanical properties of this gel were improved through a new synthetic process. In this article the biocompatibility and various mechanical properties of the new improved PVA-H is reported from the perspective of its usefulness as an artificial articular cartilage. As regards lubrication, the changes in thickness and fluid pressure of the gap formed between a glass plate and the specimen under loading were measured and it was found that PVA-H had a thicker fluid film under higher pressures than polyethylene (PE) did. The momentary stress transmitted through the specimen revealed that PVA-H had a lower peak stress and a longer duration of sustained stress than PE, suggesting a better damping effect. The wear factor of PVA-H was approximately five times that of PE. Histological studies of the articular cartilage and synovial membranes around PVA-H implanted for 8-52 weeks showed neither inflammation nor degenerative changes. The artificial articular cartilage made from PVA-H could be attached to the underlying bone using a composite osteochondral device made from titanium fibre mesh. In the second phase of this work, the damage to the tibial articular surface after replacement of the femoral surface in dogs was studied. Pairs of implants made of alumina, titanium or PVA-H on titanium fibre mesh were inserted into the femoral condyles. The two hard materials caused marked pathological changes in the articular cartilage and menisci, but the hydrogel composite replacement caused minimal damage. The composite osteochondral device became rapidly attached to host bone by ingrowth into the supporting mesh. The clinical implications of the possible use of this material in articular resurfacing and joint replacement are discussed.
authors.affiliation: Department of Tissue Regeneration, Institute for Frontier Medical Science, Kyoto University, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Oka
authors.forename: K
authors.initials: K
authors.lastname: Ushio
authors.forename: P
authors.initials: P
authors.lastname: Kumar
authors.forename: K
authors.initials: K
authors.lastname: Ikeuchi
authors.forename: S H
authors.initials: SH
authors.lastname: Hyon
authors.forename: T
authors.initials: T
authors.lastname: Nakamura
authors.forename: H
authors.initials: H
authors.lastname: Fujita
mesh_terms: D000537:Aluminum Oxide; D000818:Animals; D001672:Biocompatible Materials; D002358:Cartilage, Articular / Q000473:pathology* / Q000502:physiology*; D004285:Dogs; D005269:Femur / Q000473:pathology; D020100:Hydrogels; D007595:Joint Prosthesis; D007719:Knee Joint / Q000166:cytology / Q000502:physiology; D008153:Lubrication; D008422:Materials Testing; D008592:Menisci, Tibial / Q000473:pathology; D016348:Osseointegration / Q000502:physiology; D011095:Polyethylenes; D011142:Polyvinyl Alcohol; D011474:Prosthesis Design / Q000295:instrumentation; D011817:Rabbits; D051381:Rats; D017208:Rats, Wistar; D013314:Stress, Mechanical; D013499:Surface Properties; D013977:Tibia / Q000473:pathology; D014025:Titanium; D016474:Weight-Bearing / Q000502:physiology
chemical_list: D001672:Biocompatible Materials; D020100:Hydrogels; D011095:Polyethylenes; C111601:ultra-high molecular weight polyethylene; D011142:Polyvinyl Alcohol; D014025:Titanium; D000537:Aluminum Oxide