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Fixation and Mechanical Properties of Implanted Cartilage Replacements - An overview

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  • Fixation and Mechanical Properties of Implanted Cartilage Replacements - An overview

    I would like to share with the biomechanics research community our findings from three computational studies on mechanical properties of articular cartilage implants. Tissue-engineered cartilage implants offer great potential for the repair of cartilage lesions and there is a need for further research on mechanical properties of these implants. I hope our studies will motivate other researchers to further investigate cartilage implants from a biomechanical point of view.

    Partial- and full-thickness cartilage lesions of the knee caused by trauma, disease or joint instability are a common disorder affecting people of all ages. Implanted cartilage replacements (ICR) have the potential to overcome the limitations of conventional treatment methods and are a promising approach to restore functionality of the joint. In spite of some success in engineering cartilaginous tissue, inferior biomechanical and biochemical properties of ICR compared to native articular cartilage (AC) and inadequate quality of fixation and integrative repair of tissues remain significant clinical challenges.

    An axisymmetric biphasic swelling finite element (FE) study was conducted to elucidate the effects of a lower modulus, lower proteoglycan content and a lack of integration at the interface on the mechanical environment of a transplanted ICR in the knee joint. In comparison to intact joint, load partitioning between different phases of cartilage was affected by inferior properties of the ICR. Analysis of the relative sliding at the ICR/native AC interface suggested that when subjected to axial loading, an implant with inferior properties does not disrupt the integrative repair process anymore than an ideal implant.

    In the first study, the process of delamination at the interface could not be explored because the model was limited to the cases of full integration or no integration at the interface. Thus in the next study, a three-dimensional FE analysis was conducted to investigate damage in fibrin adhesive under conditions that included sliding loads.

    Damage and failure of fibrin at the interface was represented by a cohesive zone model with coefficients based on previously published experimental data. Results of this study demonstrated that fibrin glue alone may not be strong enough to withstand physiologic loads in vivo while fibrin glue combined with chondrocytes may effectively prevent damage at the interface. The results also suggested that fibrin fails mainly in shear during off-axis loading.

    Finally a third FE study was performed to evaluate the effect of several important implant material and geometric properties on the failure of the adhesive bond between the ICR and native tissue. Results of this study demonstrated that ICR size and material properties have a significant effect on the failure of the fibrin that adheres the implant to the native tissue. In the future, results of these studies may be used to improve implant design and surgical techniques and eventually help researchers develop more efficient and successful long-term biological articular joint repair.

    [1] Vahdati, A., Wagner, D.R., “Finite Element Study of a Tissue-engineered Cartilage Transplant in Human Tibiofemoral Joint”, Computer Methods in Biomechanics and Biomedical Engineering, 2012, 15 (11), pp. 1211-1221.
    Most tissue-engineered cartilage constructs are more compliant than native articular cartilage (AC) and are poorly integrated to the surrounding tissue. To investigate the effect of an implanted tissue-engineered construct (TEC) with these inferior properties on the mechanical environment of both th …


    [2] Vahdati, A., Wagner, D.R., “Investigation of Required Mechanical Properties of Adhesive Bond between Native and Tissue-Engineered Cartilage”. ASME Journal of Biomechanical Engineering, 2012, 134 (11), pp. 111004.
    Scaffold-based tissue-engineered constructs as well as cell-free implants offer promising solutions to focal cartilage lesions. However, adequate mechanical stability of these implants in the lesion is required for successful repair. Fibrin is the most common clinically available adhesive for cartil …


    [3] Vahdati, A., Wagner, D.R., “Role of Implant Size and Mechanical Properties on Failure of Adhesive Bond between Cartilage Implant and Native Tissue”. Journal of Biomechanics. Volume 46, Issue 9, 2013,
    Implanted cartilage replacements (ICRs) are a promising approach to restore the functionality of joints with partial- and full-thickness articular cartilage lesions. Two major hurdles hindering successful repair of cartilage injuries with ICRs are their inadequate mechanical properties and fixation …
    Last edited by Ali Vahdati; December 4, 2013, 10:20 AM. Reason: updated links to articles
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