title: Bioreactor based engineering of large-scale human cartilage grafts for joint resurfacing.
abstract: Apart from partial or total joint replacement, no surgical procedure is currently available to treat large and deep cartilage defects associated with advanced diseases such as osteoarthritis. In this work, we developed a perfusion bioreactor system to engineer human cartilage grafts in a size with clinical relevance for unicompartmental resurfacing of human knee joints (50 mm diameter × 3 mm thick). Computational fluid dynamics models were developed to optimize the flow profile when designing the perfusion chamber. Using the developed system, human chondrocytes could be seeded throughout large 50 mm diameter scaffolds with a uniform distribution. Following two weeks culture, tissues grown in the bioreactor were viable and homogeneously cartilaginous, with biomechanical properties approaching those of native cartilage. In contrast, tissues generated by conventional manual production procedures were highly inhomogeneous and contained large necrotic regions. The unprecedented engineering of human cartilage tissues in this large-scale opens the practical perspective of grafting functional biological substitutes for the clinical treatment for extensive cartilage defects, possibly in combination with surgical or pharmacological therapies to support durability of the implant. Ongoing efforts are aimed at integrating the up-scaled bioreactor based processes within a fully automated and closed manufacturing system for safe, standardized, and GMP compliant production of large-scale cartilage grafts.
authors.affiliation: Department of Surgery and of Biomedicine, University Hospital Basel, Hebelstrasse 20, 4031 Basel, Switzerland.
authors.forename: Rosaria
authors.initials: R
authors.lastname: Santoro
authors.forename: Andy L
authors.initials: AL
authors.lastname: Olivares
authors.forename: Gerben
authors.initials: G
authors.lastname: Brans
authors.forename: Dieter
authors.initials: D
authors.lastname: Wirz
authors.forename: Cristina
authors.initials: C
authors.lastname: Longinotti
authors.forename: Damien
authors.initials: D
authors.lastname: Lacroix
authors.forename: Ivan
authors.initials: I
authors.lastname: Martin
authors.forename: David
authors.initials: D
authors.lastname: Wendt
mesh_terms: D001178:Arthroplasty / Q000379:methods*; D001696:Biomechanical Phenomena; D019149:Bioreactors; D002356:Cartilage / Q000637:transplantation*; D003198:Computer Simulation; D006025:Glycosaminoglycans / Q000378:metabolism; D006801:Humans; D007596:Joints / Q000601:surgery*; D010477:Perfusion; D012212:Rheology; D023822:Tissue Engineering / Q000295:instrumentation*
chemical_list: D006025:Glycosaminoglycans