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. 2024 Jan 10;11(1):230431.
doi: 10.1098/rsos.230431. eCollection 2024 Jan.

Functional performance of a bi-layered chitosan-nano-hydroxyapatite osteochondral scaffold: a pre-clinical in vitro tribological study

Raelene M Cowie  1 , Laura Macri-Pellizzeri  2 , Jane McLaren  3 , William J Sanderson  1 , Reda M Felfel  4   5   6 , Colin A Scotchford  4 , Brigitte E Scammell  3 , David M Grant  4 , Virginie Sottile  2   7 , Louise M Jennings  1
Affiliations

Functional performance of a bi-layered chitosan-nano-hydroxyapatite osteochondral scaffold: a pre-clinical in vitro tribological study

Raelene M Cowie et al. R Soc Open Sci. .

Abstract

Osteochondral grafts are used for repair of focal osteochondral lesions. Autologous grafts are the gold standard treatment; however, limited graft availability and donor site morbidity restrict use. Therefore, there is a clinical need for different graft sources/materials which replicate natural cartilage function. Chitosan has been proposed for this application. The aim of this study was to assess the biomechanics and biotribology of a bioresorbable chitosan/chitosan-nano-hydroxyapatite osteochondral construct (OCC), implanted in an in vitro porcine knee experimental simulation model. The OCC implanted in different surgical positions (flush, proud and inverted) was compared to predicate grafts in current clinical use and a positive control consisting of a stainless steel graft implanted proud of the cartilage surface. After 3 h (10 800 cycles) wear simulation under a walking gait, subsidence occurred in all OCC samples irrespective of surgical positioning, but with no apparent loss of material and low meniscus wear. Half the predicate grafts exhibited delamination and scratching of the cartilage surfaces. No graft subsidence occurred in the positive controls but wear and deformation of the meniscus were apparent. Implanting a new chitosan-based OCC either optimally (flush), inverted or proud of the cartilage surface resulted in minimal wear, damage and deformation of the meniscus.

Keywords: chitosan; joint simulation; natural knee joint; osteochondral graft; tribology.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1.
Figure 1.
A natural porcine knee set up in a knee simulator. The gaitor (that contains the lubricant) has been removed to aid visualization of the joint. The axes of motion of the simulator are shown with solid lines representing driven axes (axial force, flexion/extension, tibial rotation), dashed lines representing either spring constrained (anterior–posterior displacement), fixed (medial–lateral displacement) or free (abduction/adduction) axes.
Figure 2.
Figure 2.
Input axial force (N), flexion/extension (°) and tibial rotation (°).
Figure 3.
Figure 3.
OCC implanted flush with the cartilage surface in a porcine medial condyle.
Figure 4.
Figure 4.
Representative images of the grafts implanted in porcine medial femoral condyles following 3 h wear simulation.
Figure 5.
Figure 5.
Representative images of the meniscus opposing the graft following 3 h wear simulation. When discoloration of the meniscus was visible, optical photographs have been used; for changes in surface topography, measurements of the meniscus taken from replicas of the cartilage surfaces have been provided.
Figure 6.
Figure 6.
Mean (± s.e.m.) cartilage grade on the femoral condyles and tibial plateau measured on the ICRS scale, and the menisci measured on the OARSI scale, n = 4.
Figure 7.
Figure 7.
Representative microCT images of grafts following 3 h simulation. Top: OCC flush (with cartilage-like (*) and bone-like (Δ) regions highlighted). Bottom: predicate (indicated by ◯). The images on the left and right show the lateral and top views from the same samples, respectively. OCC recipient site 8 mm in diameter; predicate recipient site 7.5 mm in diameter.
See this image and copyright information in PMC

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