The use of a hydrogel implant in the repair of osteochondral defects of the knee: A biomechanical evaluation of restoration of native contact pressures in cadaver knees

Sismondo, Ronald A.; Werner, Frederick W.; Ordway, Nathaniel R.; Osaheni, Allen O.; Blum, Michelle; Scuderi, Matthew G.

doi:10.1016/j.clinbiomech.2019.04.016

Cited by 11 publications

(8 citation statements)

References 17 publications

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“…50 Finally, all implants were placed 0.2 mm proud, which improves the loadbearing capabilities of the implants 19,25 and avoids potential damage to opposing tissue in versions that have been kept as much as 1 mm proud. 53 Of all implants tested, 20% PVA 1 pTi resulted in no significant difference in the sum of forces in the defect ROI when compared with the intact condition; a significant decrease in the sum of forces in the M-C ROI versus defect at 14% of the gait cycle; and a significant increase in the sum of forces in the C-C ROI versus defect at 45% of the gait cycle. In addition, the WCoCS in the anterior-posterior direction was not significantly different from the intact condition for the 20% PVA 1 pTi device.…”

Section: Discussionmentioning

confidence: 83%

“…The ability of implants to mechanically function within the knee joint should ideally form part of the preclinical evaluation process, 38 but because of the complexity of creating cadaveric models that can mimic physiological loads, such evaluations are rare. Sismondo et al 53 used a cadaveric model that applied one-third of physiological forces to quantify the ability of a PVA hydrogel implant to restore the stress distribution with a focal articular cartilage defect. Other studies have included an assessment of scaffold fixation during simulated continuous passive motion 20 and analyses of the effect of osteochondral graft height on contact mechanics.…”

Section: Discussionmentioning

confidence: 99%

“…50 Finally, all implants were placed 0.2 mm proud, which improves the load-bearing capabilities of the implants 19,25 and avoids potential damage to opposing tissue in versions that have been kept as much as 1 mm proud. 53…”

Section: Discussionmentioning

confidence: 99%

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Synthetic PVA Osteochondral Implants for the Knee Joint: Mechanical Characteristics During Simulated Gait

et al. 2021

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Background: Although polyvinyl alcohol (PVA) implants have been developed and used for the treatment of femoral osteochondral defects, their effect on joint contact mechanics during gait has not been assessed. Purpose/Hypothesis: The purpose was to quantify the contact mechanics during simulated gait of focal osteochondral femoral defects and synthetic PVA implants (10% and 20% by volume of PVA), with and without porous titanium (pTi) bases. It was hypothesized that PVA implants with a higher polymer content (and thus a higher modulus) combined with a pTi base would significantly improve defect-related knee joint contact mechanics. Study Design: Controlled laboratory study. Methods: Four cylindrical implants were manufactured: 10% PVA, 20% PVA, and 10% and 20% PVA disks mounted on a pTi base. Devices were implanted into 8 mm–diameter osteochondral defects created on the medial femoral condyles of 7 human cadaveric knees. Knees underwent simulated gait and contact stresses across the tibial plateau were recorded. Contact area, peak contact stress, the sum of stress in 3 regions of interest across the tibial plateau, and the distribution of stresses, as quantified by tracking the weighted center of contact stress throughout gait, were computed for all conditions. Results: An osteochondral defect caused a redistribution of contact stress across the plateau during simulated gait. Solid PVA implants did not improve contact mechanics, while the addition of a porous metal base led to significantly improved joint contact mechanics. Implants consisting of a 20% PVA disk mounted on a pTi base significantly improved the majority of contact mechanics parameters relative to the empty defect condition. Conclusion: The information obtained using our cadaveric test system demonstrated the mechanical consequences of femoral focal osteochondral defects and provides biomechanical support to further pursue the efficacy of high-polymer-content PVA disks attached to a pTi base to improve contact mechanics. Clinical Relevance: As a range of solutions are explored for the treatment of osteochondral defects, our preclinical cadaveric testing model provides unique biomechanical evidence for the continued investigation of novel solutions for osteochondral defects.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

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Synthetic PVA Osteochondral Implants for the Knee Joint: Mechanical Characteristics During Simulated Gait

et al. 2021

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“…Traditionally, polymer networks are infused by small molecules to form liquid gels, such as hydrogels or organogels. The infusion of a fluid phase into the polymer networks will significantly enhance the chain relaxation and reduce the internal frictions, leading to inferior damping property 29 – 31 . Even although these gels can improve the damping performance by using phase transition behavior, this behavior only occurs at certain temperature conditions and makes them mechanically unstable 25 .…”

Section: Resultsmentioning

confidence: 99%

Ultrahigh energy-dissipation elastomers by precisely tailoring the relaxation of confined polymer fluids

Huang

et al. 2021

Nat Commun

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Energy-dissipation elastomers relying on their viscoelastic behavior of chain segments in the glass transition region can effectively suppress vibrations and noises in various fields, yet the operating frequency of those elastomers is difficult to control precisely and its range is narrow. Here, we report a synergistic strategy for constructing polymer-fluid-gels that provide controllable ultrahigh energy dissipation over a broad frequency range, which is difficult by traditional means. This is realized by precisely tailoring the relaxation of confined polymer fluids in the elastic networks. The symbiosis of this combination involves: elastic networks forming an elastic matrix that displays reversible deformation and polymer fluids reptating back and forth to dissipate mechanical energy. Using prototypical poly (n-butyl acrylate) elastomers, we demonstrate that the polymer-fluid-gels exhibit a controllable ultrahigh energy-dissipation property (loss factor larger than 0.5) with a broad frequency range (10−2 ~ 108 Hz). Energy absorption of the polymer-fluid-gels is over 200 times higher than that of commercial damping materials under the same dynamic stress. Moreover, their modulus is quasi-stable in the operating frequency range.

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“…Examples are zwitterionic polymers like polysulfobetaine (PMEDSAH), [ 28,87 ] or common ionic compounds that contain aluminum ions [ 88 ] or iron ions. [ 89,90 ] PVA hydrogels are toughened by adding compounds with the above‐mentioned ions.…”

Section: Strengthening Mechanisms and Basic Property Characterizationmentioning

confidence: 99%

PVA‐Based Hydrogels: Promising Candidates for Articular Cartilage Repair

Chen

Song

Wang

et al. 2021

Macromolecular Bioscience

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The complex, gradient physiological structure of articular cartilage is a severe hindrance of its self‐repair, leaving the clinical treatment of cartilage defects a demanding issue to be addressed. Currently applied tissue engineering treatments and traditional non‐tissue engineering treatments have different limitations, for example, cell dedifferentiation, immune rejection, and prosthesis‐related complications. Thus, studies have been focusing on seeking promising candidates for novel cartilage repair methods. Polyvinyl alcohol (PVA) hydrogels with excellent biocompatibility and tunable material properties have become the alternatives. For pure PVA hydrogels, the mechanical strength and lubricity are not capable of replacing articular cartilage until proper modifications are done. This paper summarizes the research progress in PVA hydrogels, including the preparation, modification, and cartilage‐repair‐aimed biomimetic improvements. Design guidance of PVA hydrogels is put forward as assistance to functional hydrogel preparation. Finally, the prospects and main obstacles of PVA hydrogels are discussed.

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The use of a hydrogel implant in the repair of osteochondral defects of the knee: A biomechanical evaluation of restoration of native contact pressures in cadaver knees

Cited by 11 publications

References 17 publications

Synthetic PVA Osteochondral Implants for the Knee Joint: Mechanical Characteristics During Simulated Gait

Synthetic PVA Osteochondral Implants for the Knee Joint: Mechanical Characteristics During Simulated Gait

Ultrahigh energy-dissipation elastomers by precisely tailoring the relaxation of confined polymer fluids

PVA‐Based Hydrogels: Promising Candidates for Articular Cartilage Repair

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