title: Comparison of Fixation Techniques of 3D-Woven Poly(ϵ-Caprolactone) Scaffolds for Cartilage Repair in a Weightbearing Porcine Large Animal Model.
abstract: Objective To test different fixation methods of a 3-dimensionally woven poly(ϵ-caprolactone) (PCL) scaffold within chondral defects of a weightbearing large animal model. Methods Full thickness chondral defects were made in the femoral condyles of 15 adult male Yucatan mini-pigs. Two surgical approaches were compared including total arthrotomy (traditional) and a retinaculum-sparing, minimally invasive surgery (MIS) approach. Following microfracture (MFX), scaffolds were placed without fixation or were fixed with fibrin glue, suture, or subchondral anchor. Experimental endpoints were between 1 and 6 weeks. Micro-computed tomography and histology were used to assess samples. Results The MIS approach was superior as the traditional approach caused medial condyle cartilage wear. One of 13 (7.7%) of scaffolds without fixation, 4 of 11 (36.3%) fibrin scaffolds, 1 of 4 (25%) of sutured scaffolds, and 9 of 9 (100%) of anchor-fixed scaffolds remained in place. Histology demonstrated tissue filling with some overgrowth of PCL scaffolds. Conclusions Of the methods tested, the MIS approach coupled with subchondral anchor fixation provided the best scaffold retention in a mini-pig chondral defect model. This finding has implications for fixation strategies in future animal studies and potential future human use.
authors.affiliation: 1 Department of Orthopaedic Surgery, McKay Orthopaedic Research Lab, University of Pennsylvania, Philadelphia, PA, USA.|2 Translational Musculoskeletal Research Center, Philadelphia VA Medical Center, Philadelphia, PA, USA.
authors.forename: James M
authors.initials: JM
authors.lastname: Friedman
authors.affiliation: 1 Department of Orthopaedic Surgery, McKay Orthopaedic Research Lab, University of Pennsylvania, Philadelphia, PA, USA.|2 Translational Musculoskeletal Research Center, Philadelphia VA Medical Center, Philadelphia, PA, USA.
authors.forename: Mackenzie L
authors.initials: ML
authors.lastname: Sennett
authors.affiliation: 3 Department of Orthopedic Surgery, University of São Paulo, São Paulo, Brazil.
authors.forename: Marcelo B
authors.initials: MB
authors.lastname: Bonadio
authors.affiliation: 1 Department of Orthopaedic Surgery, McKay Orthopaedic Research Lab, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Kerry O
authors.initials: KO
authors.lastname: Orji
authors.affiliation: 1 Department of Orthopaedic Surgery, McKay Orthopaedic Research Lab, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Alexander L
authors.initials: AL
authors.lastname: Neuwirth
authors.affiliation: 1 Department of Orthopaedic Surgery, McKay Orthopaedic Research Lab, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Niobra
authors.initials: N
authors.lastname: Keah
authors.affiliation: 1 Department of Orthopaedic Surgery, McKay Orthopaedic Research Lab, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: James L
authors.initials: JL
authors.lastname: Carey
authors.affiliation: 4 Cytex Therapeutics, Durham, NC, USA.
authors.forename: Franklin T
authors.initials: FT
authors.lastname: Moutos
authors.affiliation: 4 Cytex Therapeutics, Durham, NC, USA.
authors.forename: Bradley T
authors.initials: BT
authors.lastname: Estes
authors.affiliation: 4 Cytex Therapeutics, Durham, NC, USA.|5 Department of Orthopaedic Surgery, Washington University in St. Louis and Shriners Hospitals for Children-St. Louis, St. Louis, MO, USA.|7 Collaborative Research Partnership-Acute Cartilage Injury Program, AO Foundation, Davos, Switzerland.
authors.forename: Farshid
authors.initials: F
authors.lastname: Guilak
authors.affiliation: 6 Department of Orthopaedic Surgery, Saarland University Medical Center, Homberg/Saar, Germany.|7 Collaborative Research Partnership-Acute Cartilage Injury Program, AO Foundation, Davos, Switzerland.
authors.forename: Henning
authors.initials: H
authors.lastname: Madry
authors.affiliation: 1 Department of Orthopaedic Surgery, McKay Orthopaedic Research Lab, University of Pennsylvania, Philadelphia, PA, USA.|2 Translational Musculoskeletal Research Center, Philadelphia VA Medical Center, Philadelphia, PA, USA.|7 Collaborative Research Partnership-Acute Cartilage Injury Program, AO Foundation, Davos, Switzerland.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Mauck
authors.affiliation: 1 Department of Orthopaedic Surgery, McKay Orthopaedic Research Lab, University of Pennsylvania, Philadelphia, PA, USA.|2 Translational Musculoskeletal Research Center, Philadelphia VA Medical Center, Philadelphia, PA, USA.|7 Collaborative Research Partnership-Acute Cartilage Injury Program, AO Foundation, Davos, Switzerland.
authors.forename: George R
authors.initials: GR
authors.lastname: Dodge
mesh_terms: D000818:Animals; D001182:Arthroscopy / Q000379:methods*; D002208:Caproates; D002357:Cartilage Diseases / Q000503:physiopathology / Q000601:surgery*; D002358:Cartilage, Articular / Q000601:surgery; D004195:Disease Models, Animal; D015718:Fibrin Tissue Adhesive; D007783:Lactones; D008297:Male; D013552:Swine; D013556:Swine, Miniature; D023822:Tissue Engineering / Q000379:methods*; D054457:Tissue Scaffolds; D016474:Weight-Bearing
chemical_list: D002208:Caproates; D015718:Fibrin Tissue Adhesive; D007783:Lactones; C121056:caprolactone
keywords: PCL; articular cartilage; fixation; repair; scaffold