Positive experience of full-layer filling of articular cartilage defect using a degradable implant with a bioactive surface in combination with platelet-rich blood plasma (experimental study)

Popkov A.V., Popkov D.A., Kobyzev A.E., Gorbach E.N., Kononovich N.A., Gorbach E.S.

Abstract


Defects of the cartilage surface are a frequent joint damage in orthopaedic practice. First of all, they arise as a result of high-energy trauma or a consequence of chronic systemic diseases. In both cases, incongruence of the articular surfaces leads to the development of osteoarthritis. Joint resistance to residual incongruence depends on the depth and area of the damage, as well as on the thickness of the articular cartilage. The restoration of cartilage defects in the knee joint remains one of the urgent problems of modern orthopedics and traumatology.
Purpose
Search for new methods for filling extensive defects of the articular cartilage of joint surfaces with the possibility of restoring a typical joint structure
Materials and methods
Using clinical, microanatomical, and histological methods, a study was conducted to investigate the possibility of filling the defect of the joint surface of the femoral condyles of adult mongrel dogs (n = 3) with a thin elastic polycaprolactone woven by electrospinning, the threads of which are coated with hydroxyapatite nanoparticles, in combination with the introduction of an enriched platelet blood autoplasma into the defect.
Results
After 60 days of the experiment, restoration of the congruence of the articular surface along with mosaic-like replacement of the implanted material in the region of the cartilaginous layer with portions of hyaline-like cartilage and in the subchondral bone zone with a new cancellous bone tissue was noted. In the defect of the articular surface of the control animals, which was not filled with a bioactive implant, vascularized loose fibrous connective tissue was formed after 60 days of the experiment.
Conclusion
The results obtained may be promising in terms of the possibility of prolonging the functional ability of joints in patients with articular cartilage defects; after further longer experimental and clinical observations) may offer a new universal method for filling articular defects of various etiologies to restore their biomechanics and typical strudcture.

Keywords


articular cartilage defect, experiment, graft, polycaprolactone, hydroxyapatite, reparative regeneration, transosseous osteosynthesis

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DOI: http://dx.doi.org/10.18019/1028-4427-2020-26-3-392-397

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