The performance of resurfacing implants for focal cartilage defects depends on the degenerative condition of the opposing cartilage

Damen, A H A; Nickien, Mieke; Ito, Keita; Donkelaar, Corrinus C. van

doi:10.1016/j.clinbiomech.2020.105052

Cited by 8 publications

(7 citation statements)

References 31 publications

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“…8,9,17 This is of particular importance, since contact mechanics of PCU against a rough surface, such as an arthritic joint surface, both exhibit and induce accelerated wear. 18 Navigated resurfacing has already been described with positive outcomes in humans and laboratory animals. [19][20][21][22] Comparisons between several studies showed that surgical guides improved the surgical outcome and decreased surgery time.…”

Section: Discussionmentioning

confidence: 99%

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Fully Guided Synthetic Osteochondral Resurfacing of a Large Stifle OCD Lesion Using a Patient-Specific Implant and Drill Guides

Moser

Haimel²,

Barker-Benfield³

et al. 2023

VCOT Open

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Synthetic anatomical reconstruction of extensive, oval osteochondrosis dissecans (OCD) defects remains a challenge due to the ‘one shape fits all’ design of commercial round implants. This is further complicated by the inherent inaccuracy of free-hand implant positioning procedures. A 6-month-old German Shepherd presented with a 15 × 7.8 × 4.3 mm OCD defect at the lateral femoral condyle. A synthetic patient-specific implant (PSI) was designed, using the contralateral unaffected condyle as a template. Reaming of the implant bed was fully guided using a set of three-dimensional-printed drill guides. The implant, consisting of a titanium base and a polycarbonate urethane bearing surface, was press-fit into place. Temporary meniscal release of the cranial meniscal horn was repaired, followed by routine closure and postoperative care. The combination of PSI and matching drill guides resulted in an accurate restoration of the normal joint surface at the former defect area. At 6-week and 18-month follow-ups, mild joint effusion, unexpected soft tissue mineralization and a small joint mouse were present. No other complications were encountered, and the dog was clinically lameness-free. At 6 weeks and 6 months, computerized gait analysis documented increased loading of the affected limb from 36% preoperatively to 42 and 40%, on follow-up, respectively. Body weight distribution between both hindlimbs was nearly equal at the 6-month control with 1% difference in loading. Osteochondral resurfacing using a PSI appears to be a promising treatment option for large stifle OCD lesions in which other treatment modalities may not be eligible.

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Section: Discussionmentioning

confidence: 99%

“…8 9 17 This is of particular importance, since contact mechanics of PCU against a rough surface, such as an arthritic joint surface, both exhibit and induce accelerated wear. 18…”

Section: Discussionmentioning

confidence: 99%

Fully Guided Synthetic Osteochondral Resurfacing of a Large Stifle OCD Lesion Using a Patient-Specific Implant and Drill Guides

Moser

Haimel²,

Barker-Benfield³

et al. 2023

VCOT Open

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“…Early intervention osteochondral therapies in the form of metal focal knee resurfacing implants (FKRIs) are currently one of the treatment options used to repair cartilage defects in these patients 3–5 . However, as the biomechanical properties of metal implants do not match those of cartilage, these implants can cause a gradual increase in the amount of cartilage damage in the surrounding and opposing tissue 6–10 . In addition to this, MRI diagnostics can no longer be used to visualize and monitor future or recurrent complaints when metal FKRIs are used.…”

Section: Introductionmentioning

confidence: 99%

“… 3 , 4 , 5 However, as the biomechanical properties of metal implants do not match those of cartilage, these implants can cause a gradual increase in the amount of cartilage damage in the surrounding and opposing tissue. 6 , 7 , 8 , 9 , 10 In addition to this, MRI diagnostics can no longer be used to visualize and monitor future or recurrent complaints when metal FKRIs are used.…”

Section: Introductionmentioning

confidence: 99%

Surface texture analysis of different focal knee resurfacing implants after 6 and 12 months in vivo in a goat model

Aşık

Damen

Hugten

et al. 2022

Journal Orthopaedic Research

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The clinical success of osteochondral implants depends significantly on their surface properties. In vivo, an implant may roughen over time which can decrease its performance. The present study investigates whether changes in the surface texture of metal and two types of polycarbonate urethane (PCU) focal knee resurfacing implants (FKRIs) occurred after 6 and 12 months of in vivo articulation with native goat cartilage. PCU implants which differed in stem stiffness were compared to investigate whether the stem fixating the implant in the bone influences surface topography. Using optical profilometry, 19 surface texture parameters were evaluated, including spatial distribution and functional parameters obtained from the material ratio curve. For metal implants, wear during in vivo articulation occurred mainly via material removal, as shown by the significant decrease of the core‐valley transition from 91.5% in unused implants to 90% and 89.6% after 6 and 12 months, respectively. Conversely, for PCU implants, the wear mechanism consisted in either filling of the valleys or flattening of the surface by dulling of sharp peaks. This was illustrated in the change in roughness skewness from negative to positive values over 12 months of in vivo articulation. Implants with a softer stem experienced the most deformation, shown by the largest change in material ratio curve parameters. We therefore showed, using a detailed surface profilometry analysis, that the surface texture of metal and two different PCU FKRIs changes in a different way after articulation against cartilage, revealing distinct wear mechanisms of different implant materials.

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“…Nowadays, these implants are made of metals. These materials are much stiffer than the native cartilage it replaces and the articulating surfaces of these implants lack lubricating properties, leading to damage of the opposing and adjacent cartilage, [4][5][6][7] especially when the implants protrude above the surrounding articulating cartilage surface or are placed at an angle. [8][9][10][11] As an alternative to rigid metal implants, hydrogels are gaining attention as a matrix material for soft tissue replacement.…”

Section: Introductionmentioning

confidence: 99%

The effect of HydroSpacer implant placement on the wear of opposing and adjacent cartilage

Damen

Schuiringa

Ito

et al. 2022

Journal Orthopaedic Research

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A HydroSpacer implant, that is, a swelling hydrogel confined by a spacer fabric, was developed to repair focal cartilage defects and to prevent progression into osteoarthritis. The present study evaluated the effect of implant placement height in an osteochondral (OC) plug on wear of the opposing and adjacent cartilage. Three‐dimensional warp‐knitted spacer fabrics, polycaprolactone with poly(4‐hydroxybutyrate) pile yarns, were filled with a hyaluronic acid methacrylate and chondroitin sulfate methacrylate hydrogel. After polymerization of the hydrogel, these HydroSpacers were implanted in OC defects (ø 6 mm) created in bovine OC plugs (ø 10 mm) and allowed to swell to equilibrium. A custom‐made pin‐on‐plate wear apparatus was used to apply simultaneous compression and sliding against bovine cartilage. Cartilage damage, visualized with Indian ink, was only seen for the group in which the HydroSpacer was placed flush with the surrounding cartilage. A significant increase on average surface roughness of the sliding path compared to the adjacent cartilage confirmed surface damage for this group. When the implants were recessed (with and without extra hydrogel layer on top of the implant), this damage was not observed, but the cartilage surrounding the implants was compressed (without damage) indicating substantial load sharing with the implant. Furthermore, it was shown that all defects treated with a HydroSpacer implant resulted in shear forces comparable to intact cartilage. Clinical significance: The present study suggests that placing a HydroSpacer implant recessed into the surrounding cartilage would decrease wear of the opposing cartilage. Altogether, this study supports the development of textile‐constraining hydrogels for cartilage replacement.

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The performance of resurfacing implants for focal cartilage defects depends on the degenerative condition of the opposing cartilage

Cited by 8 publications

References 31 publications

Fully Guided Synthetic Osteochondral Resurfacing of a Large Stifle OCD Lesion Using a Patient-Specific Implant and Drill Guides

Fully Guided Synthetic Osteochondral Resurfacing of a Large Stifle OCD Lesion Using a Patient-Specific Implant and Drill Guides

Surface texture analysis of different focal knee resurfacing implants after 6 and 12 months in vivo in a goat model

The effect of HydroSpacer implant placement on the wear of opposing and adjacent cartilage

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