Regeneration of Osteochondral Lesion of the Talus with Retrograde Drilling Technique: An In Vitro Pilot Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. OC Sample Harvesting and Surgical Set-Up of OCLT
- Group 1—control untreated (CTR): the defect created was left empty and not treated (empty defect);
- Group 2—treated with ABG: to simulate the clinical surgical procedure, for bone drainage with ABG, the technique developed by Taranow WS et al. was used [20], a method widely validated in the literature which proved to be indicated in the presence of subchondral cystic lesions with vital cartilage [4,14,16]. The created defect was filled with the obtained spongy bone graft, deposited beneath the subchondral plate and adequately packed to prevent it from leaving the defect.
- Group 3—involved a similar retrograde perforation, removing all the subchondral bone and keeping the overlying cartilaginous layer intact, but the defect was treated with the HyaloFast® (Anika Therapeutics, Inc.—Bedford, MA 01730 USA) scaffold: HYAFF® (hyaluronic acid benzyl ester) is a scaffold usually used as a support for the entrapment of mesenchymal stem cells (MSCs) and for the repair of chondral and osteochondral lesions. The created defect was filled with HyaloFast® scaffolds and bone marrow cells harvested from the tibial medullary canal emerging through the tibial holes of the surgical instruments (2 mL) during the preparatory phase for the positioning of the prosthesis.
2.2. Culture Conditions
2.3. Tissue Viability
2.4. Immunoenzymatic Analysis
2.5. Microtomographic Analysis
- -
- Bone density BV/TV (%), expressed as the ratio between the volume of the trabecular bone and the total volume of the VOI;
- -
- Trabecular thickness Tb.Th (in mm), calculated in a model-independent manner described by Hildebrand and Ruegsegger on the entire VOI;
- -
- Trabecular separation Tb.Sp (in mm), calculated as the Tb.Th.
2.6. Histology
2.7. Statistical Analysis
3. Results
3.1. Viability
3.2. Immunoenzymatic Analysis
3.3. Microtomographic Analysis
3.4. Histology
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Inclusion Criteria | Exclusion Criteria |
---|---|
Male and female patients suffering from primary or secondary arthritis of the ankle (Kellgren–Lawrence—KL 4) | Presence of active infections at the time of inclusion in the study |
Thickness of waste osteocartilaginous tissue ≥ 3 mm | State of pregnancy |
Age ≥ 18 years | Any other pathology or state that makes surgical treatment contraindicated |
Patients able to provide written informed consent to the study | Patients suffering from autoimmune or rheumatological diseases |
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Veronesi, F.; Maglio, M.; Brogini, S.; Mazzotti, A.; Artioli, E.; Zielli, S.O.; Faldini, C.; Giavaresi, G. Regeneration of Osteochondral Lesion of the Talus with Retrograde Drilling Technique: An In Vitro Pilot Study. J. Clin. Med. 2024, 13, 4138. https://doi.org/10.3390/jcm13144138
Veronesi F, Maglio M, Brogini S, Mazzotti A, Artioli E, Zielli SO, Faldini C, Giavaresi G. Regeneration of Osteochondral Lesion of the Talus with Retrograde Drilling Technique: An In Vitro Pilot Study. Journal of Clinical Medicine. 2024; 13(14):4138. https://doi.org/10.3390/jcm13144138
Chicago/Turabian StyleVeronesi, Francesca, Melania Maglio, Silvia Brogini, Antonio Mazzotti, Elena Artioli, Simone Ottavio Zielli, Cesare Faldini, and Gianluca Giavaresi. 2024. "Regeneration of Osteochondral Lesion of the Talus with Retrograde Drilling Technique: An In Vitro Pilot Study" Journal of Clinical Medicine 13, no. 14: 4138. https://doi.org/10.3390/jcm13144138