title: One-step osteochondral repair with cartilage fragments in a composite scaffold.
abstract: OBJECTIVE
  This study proposes a single-step therapeutic approach for osteochondral defects using autologous cartilage fragments loaded onto a scaffold composed of a hyaluronic acid (HA) derivative, human fibrin glue (FG) and autologous platelet-rich-plasma (PRP), in a rabbit model. The aim is to demonstrate the in vitro outgrowth of chondrocytes from cartilage fragments and the in vivo formation of a functional repair tissue.
  
  
  METHODS
  In vitro: minced articular cartilage was loaded onto two different types of scaffold (paste or membrane) according to two different HA preparations (injectable HA-derivative or HA-derivative felt). In vivo: trochlear osteochondral defects were created in 50 adult rabbits, which were then assigned to 5 different treatment groups: cartilage fragments loaded onto membrane scaffolds with FG (Group 1) or without FG (Group 2); membrane scaffolds alone with FG (Group 3) or without FG (Group 4); empty defects (Group 5). Membrane scaffolds were used "in vivo" for simpler preparation and better adhesive properties. Repair processes were evaluated histologically and by immunohistochemistry at 1, 3, and 6 months.
  
  
  RESULTS
  An in vitro time-dependent cell outgrowth from cartilage fragments was observed with both types of scaffolds. At 6 months, in vivo, cartilage fragment-loaded scaffolds induced significantly better repair tissue than the scaffold alone using histological scoring. Repair in Group 2 was superior to that in any of the control groups (p < 0.05).
  
  
  CONCLUSIONS
  Autologous cartilage fragments loaded onto an HA felt/FG/PRP-scaffold provided an efficient cell source, and allowed for an improvement of the repair process of ostechondral defects in a rabbit model. Human FG, however, hampered the rabbit healing process. These results may have clinical relevance as they show the potential of a novel one-stage repair technique for osteochondral defects.
authors.affiliation: Department of Orthopaedics and Traumatology, University of Torino, Torino, Italy. antonio.marmotti@inwind.it
authors.forename: A
authors.initials: A
authors.lastname: Marmotti
authors.forename: M
authors.initials: M
authors.lastname: Bruzzone
authors.forename: D E
authors.initials: DE
authors.lastname: Bonasia
authors.forename: F
authors.initials: F
authors.lastname: Castoldi
authors.forename: R
authors.initials: R
authors.lastname: Rossi
authors.forename: L
authors.initials: L
authors.lastname: Piras
authors.forename: A
authors.initials: A
authors.lastname: Maiello
authors.forename: C
authors.initials: C
authors.lastname: Realmuto
authors.forename: G M
authors.initials: GM
authors.lastname: Peretti
mesh_terms: D000818:Animals; D002358:Cartilage, Articular / Q000473:pathology* / Q000601:surgery*; D019902:Chondrocytes / Q000166:cytology* / Q000637:transplantation*; D015718:Fibrin Tissue Adhesive / Q000494:pharmacology; D006820:Hyaluronic Acid / Q000494:pharmacology; D053657:Platelet-Rich Plasma / Q000187:drug effects; D011817:Rabbits; D023822:Tissue Engineering / Q000379:methods*; D054457:Tissue Scaffolds; D014182:Transplantation, Autologous / Q000379:methods; D014945:Wound Healing / Q000187:drug effects
chemical_list: D015718:Fibrin Tissue Adhesive; D006820:Hyaluronic Acid