In vivo performance of a novel silk fibroin scaffold for partial meniscal replacement in a sheep model.
In vivo performance of a novel silk fibroin scaffold for partial meniscal replacement in a sheep model.
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DOI：
10.1007/s00167-014-3009-2
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发表时间：
2015-08
期刊：
影响因子：
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通讯作者：
Dürselen L
中科院分区：
文献类型：
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作者：
Gruchenberg K;Ignatius A;Friemert B;von Lübken F;Skaer N;Gellynck K;Kessler O;Dürselen L
由于尿道切除术的负面影响，需要足够的材料来替换受损的尿道组织。到目前为止，没有测试的材料能够充分替代半月板。因此，在体内绵羊模型中研究了新的丝素蛋白支架。对28只绵羊的内侧半月板进行部分半月板切除，并在19只半月板中植入支架（3个月支架组，n = 9; 6个月支架组，n = 10）。在9只绵羊中，缺损保持为空（部分回肠切除组）。9只动物进行假手术。丝支架能够承受植入期间经历的负荷。术后6个月，支架组与假手术组的关节软骨退变无明显差异。该支架的压缩性能接近动脉组织。然而，支架并不总是稳定地固定在缺损处，导致植入物和宿主组织之间的间隙或在每个支架组的9个病例中的3个中植入物完全丧失。因此，需要改进固定技术以实现更好地整合到宿主组织中，并且支架的长期性能应进一步研究。这些关于新丝素蛋白支架的第一个体内结果为进一步的植入物开发提供了基础。虽然需要更多的数据，但有初步证据表明具有软骨保护性能，并且压缩性能和生物相容性很有希望。
Due to the negative effects of meniscectomy, there is a need for an adequate material to replace damaged meniscal tissue. To date, no material tested has been able to replace the meniscus sufficiently. Therefore, a new silk fibroin scaffold was investigated in an in vivo sheep model. Partial meniscectomy was carried out to the medial meniscus of 28 sheep, and a scaffold was implanted in 19 menisci (3-month scaffold group, n = 9; 6-month scaffold group, n = 10). In 9 sheep, the defect remained empty (partial meniscectomy group). Sham operation was performed in 9 animals. The silk scaffold was able to withstand the loads experienced during the implantation period. It caused no inflammatory reaction in the joint 6 months postoperatively, and there were no significant differences in cartilage degeneration between the scaffold and sham groups. The compressive properties of the scaffold approached those of meniscal tissue. However, the scaffolds were not always stably fixed in the defect, leading to gapping between implant and host tissue or to total loss of the implant in 3 of 9 cases in each scaffold group. Hence, the fixation technique needs to be improved to achieve a better integration into the host tissue, and the long-term performance of the scaffolds should be further investigated. These first in vivo results on a new silk fibroin scaffold provide the basis for further meniscal implant development. Whilst more data are required, there is preliminary evidence of chondroprotective properties, and the compressive properties and biocompatibility are promising.