A Novel Approach for Multiple Material Extrusion in Arthroscopic Knee Surgery

被引:1
作者
Mazzocchi, Tommaso [1 ,2 ]
Guarnera, Daniele [1 ,2 ]
Trucco, Diego [1 ,2 ,3 ]
Restaino, Francesco Rocco [1 ,2 ]
Vannozzi, Lorenzo [1 ,2 ]
Siliberto, Alessio [1 ,2 ]
Lisignoli, Gina [3 ]
Zaffagnini, Stefano [4 ]
Russo, Alessandro [4 ]
Ricotti, Leonardo [1 ,2 ]
机构
[1] Scuola Super Sant Anna, BioRobot Inst, Piazza Martiri Liberta 33, I-56127 Pisa, Italy
[2] Scuola Super Sant Anna, Dept Excellence Robot & AI, Piazza Martiri Liberta 33, I-56127 Pisa, Italy
[3] IRCCS Ist Ortoped Rizzoli, SC Lab Immunoreumatol & Rigeneraz Tissutale, Via Barbiano 1-10, I-40136 Bologna, Italy
[4] IRCCS Ist Ortoped Rizzoli, Orthopaed & Traumatol Clin, Via Barbiano 1-10, I-40136 Bologna, Italy
关键词
Cartilage regeneration; Biomaterials; Arthroscopic tools; Arthroscopic surgery; Osteoarthritis; Medical devices; ARTICULAR-CARTILAGE DEFECTS; LAWRENCE CLASSIFICATION; TISSUE; KELLGREN; REPAIR;
D O I
10.1007/s10439-022-03061-5
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
Articular cartilage defects and degenerative diseases are pathological conditions that cause pain and the progressive loss of joint functionalities. The most severe cases are treated through partial or complete joint replacement with prostheses, even if the interest in cartilage regeneration and re-growth methods is steadily increasing. These methods consist of the targeted deposition of biomaterials. Only a few tools have been developed so far for performing these procedures in a minimally invasive way. This work presents an innovative device for the direct deposition of multiple biomaterials in an arthroscopic scenario. The tool is easily handleable and allows the extrusion of three different materials simultaneously. It is also equipped with a flexible tip to reach remote areas of the damaged cartilage. Three channels are arranged coaxially and a spring-based dip-coating approach allows the fabrication and assembly of a bendable polymeric tip. Experimental tests were performed to characterize the tip, showing the ability to bend it up to 90 degrees (using a force of similar to 1.5 N) and to extrude three coaxial biomaterials at the same time with both tip straight and tip fully bent. Rheometric analysis and fluid-dynamic computational simulations were performed to analyze the fluids' behavior; the maximum shear stresses were observed in correspondence to the distal tip and the channel convergence chamber, but with values up to similar to 1.2 kPa, compatible with a safe extrusion of biomaterials, even laden with cells. The cells viability was assessed after the extrusion with Live/Dead assay, confirming the safety of the extrusion procedures. Finally, the tool was tested arthroscopically in a cadaveric knee, demonstrating its ability to deliver the biomaterial in different areas, even ones that are typically hard-to-reach with traditional tools.
引用
收藏
页码:550 / 565
页数:16
相关论文
共 56 条
[1]   Hydrogel-Based 3D Bioprinting for Bone and Cartilage Tissue Engineering [J].
Abdollahiyan, Parinaz ;
Oroojalian, Fatemeh ;
Mokhtarzadeh, Ahad ;
de la Guardia, Miguel .
BIOTECHNOLOGY JOURNAL, 2020, 15 (12)
[2]   Implantation of tissue-engineered cartilage-like tissue for the treatment for full-thickness cartilage defects of the knee [J].
Adachi, Nobuo ;
Ochi, Mitsuo ;
Deie, Masataka ;
Nakamae, Atsuo ;
Kamei, Goki ;
Uchio, Yuji ;
Iwasa, Junji .
KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, 2014, 22 (06) :1241-1248
[3]   Posterior trans-septal portal for arthroscopic surgery of the knee joint [J].
Ahn, JH ;
Ha, CW .
ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 2000, 16 (07) :774-779
[4]  
[Anonymous], 1966, ACTA RADIOLOGICA DIA, V5, P11, DOI [10.1177/0284185166005S26004, DOI 10.1177/0284185166005S26004]
[5]   Instrumentation and Technologies in Endoscopic Ear Surgery [J].
Badr-El-Dine, Mohamed ;
James, Adrian L. ;
Panetti, Giuseppe ;
Marchioni, Daniele ;
Presutti, Livio ;
Nogueira, Joao Flavio .
OTOLARYNGOLOGIC CLINICS OF NORTH AMERICA, 2013, 46 (02) :211-+
[6]   Viscosupplementation for the treatment of osteoarthritis of the knee [J].
Bellamy, N. ;
Campbell, J. ;
Robinson, V ;
Gee, T. ;
Bourne, R. ;
Wells, G. .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2006, (02)
[7]   Controlling Shear Stress in 3D Bioprinting is a Key Factor to Balance Printing Resolution and Stem Cell Integrity [J].
Blaeser, Andreas ;
Campos, Daniela Filipa Duarte ;
Puster, Uta ;
Richtering, Walter ;
Stevens, Molly M. ;
Fischer, Horst .
ADVANCED HEALTHCARE MATERIALS, 2016, 5 (03) :326-333
[8]  
Cao YL, 1998, J BIOMAT SCI-POLYM E, V9, P475
[9]   Knee replacement [J].
Carr, Andrew J. ;
Robertsson, Otto ;
Graves, Stephen ;
Price, Andrew J. ;
Arden, Nigel K. ;
Judge, Andrew ;
Beard, David J. .
LANCET, 2012, 379 (9823) :1331-1340
[10]   A review on surgical instruments of knee arthroscopic debridement and total hip arthroplasty [J].
Chen, Zhihua ;
Wang, Chengyong ;
Jiang, Wentao ;
Tang, Na ;
Chen, Bin .
3RD CIRP CONFERENCE ON BIOMANUFACTURING, 2017, 65 :291-298