Quality of scaffold fixation in a human cadaver knee model.
OBJECTIVE
Newly developed regenerative cartilage interventions based on the application of 3D-scaffolds require a further evaluation of the surgical techniques involved. The present study compared four different scaffold fixation techniques [fibrin glue (FG), transosseous (TS) fixation, biodegradable pin (BP) fixation and continuous cartilage sutures (CS)] to implant a custom-printed porous PEOT/PBT1000/70/30 scaffold in a human cadaver knee model.


METHODS
After implantation, the knees were subjected to a vertically oriented loaded continuous passive motion (CPM) protocol. The fixation techniques were evaluated after 60 and a subsequent 150 motion cycles, focusing on area coverage, outline attachment and scaffold integrity. After the total of 210 cycles, also an endpoint fixation test was performed.


RESULTS
The fixation techniques revealed marginal differences for area coverage and outline attachment after 60 and 150 cycles. The FG scored higher on scaffold integrity compared to TS (P<0.05) and CS (P=0.01). Endpoint fixation was highest for the CS, whereas FG showed a weak final fixation strength (P=0.01).


CONCLUSIONS
This study showed that optimal fixation cannot be combined always with high scaffold integrity. Special attention devoted to scaffold properties in relation to the fixation technique may result in an improvement of scaffold fixation, and thus clinical cartilage regenerative approaches involving these scaffolds.
Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands.
J E J
JE
Bekkers
A I
AI
Tsuchida
J
J
Malda
L B
LB
Creemers
R J M
RJ
Castelein
D B F
DB
Saris
W J A
WJ
Dhert
D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials; D002102:Cadaver; D002358:Cartilage, Articular / Q000293:injuries / Q000601:surgery*; D019902:Chondrocytes / Q000637:transplantation*; D005260:Female; D015718:Fibrin Tissue Adhesive; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D013536:Suture Techniques / Q000592:standards; D013537:Sutures / Q000592:standards*; D014014:Tissue Adhesives / Q000592:standards*; D054457:Tissue Scaffolds; D014182:Transplantation, Autologous
D001672:Biocompatible Materials; D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives