Tissue engineering approaches for healing cartilage defects are partly limited by the inability to fix cartilage to bone during implantation. To overcome this problem, cartilage can be - already
Generally, injuries of articular cartilage do not heal spontaneously and lead to joint pain and restricted functions [
These approaches are partly limited by a deficient fixation of engineered cartilage to bone after implantation [
The formation of an adequate connection between engineered cartilage and biomaterial is not established
The ceramic carrier used is composed of hydroxylapatite (HA), derived from porcine bone. HA offers biocompatible, bioactive, osteoconductive and in some cases even osteoinductive properties [
Several
During cartilage tissue engineering, some given factors have to be considered. The initial cell number for the generation of autologous implants is limited by the small size of a biopsy. Hence, chondrocytes have to be expanded until the required cell number is reached. But, re-differentiation became necessary after expansion, as proliferation of chondrocytes is accompanied by de-differentiation of cells. De-differentiated chondrocytes stop production of cartilage-specific extracellular matrix components, especially collagen type II and glycosaminoglycans, and acquire fibroblast-like morphology [
Thus, osteochondral implants were generated according to the following cultivation principle [
For the generation of constructs a solid carrier (Sponceram HA®, Zellwerk, Germany) with a diameter of 4.55 mm and a height of 2 mm was used. The carrier consisted of hydroxylapatite, derived by partially sintering ground porcine bone.
In this work, the surface structure of carriers was modified to determine the influence of the topography on cartilage formation
The surface topography of each carrier was characterized with the aid of a Charge-coupled Device (CCD) Camera (see below). Before cultivation, carriers were placed in phosphate-buffered saline (PBS, Roth, Germany) overnight which was followed by an autoclaving step.
For specification of the surface structure of carriers a microscope (InfiniteFocus, Alicona, Germany) with a Charge-coupled Device Camera was used which generates a xyz data set of the topography. This can be used to create a 3D image by respective post processing. Furthermore, the Alicona system can be used to generate data concerning roughness and/or wear which, however, are only to a certain but limited degree comparable with the well known data obtained by tactile measurements. Therefore, in this study only 3D images are used for evaluating the variation in surface topography as shown in Fig. (
In general, this allows a high resolution characterization (approx. at the best 10 nm in z direction and 1-2 µm in x-y direction) of rough and non-plain surfaces in non contact mode.
Chondrocytes were isolated from a knee joint (femur) of an approximately 5 month old domestic pig by using hyaluronidase type III solution (Sigma-Aldrich, Germany), trypsin (Roth) and collagenase type Ia solution (Sigma-Aldrich).
Cartilage-carrier-constructs were generated according to the concept described above [
Chondrocytes were trypsinated from the T-flasks and 2x105 chondrocytes were sedimented onto each calcium phosphate carrier (see above) to form a cell layer (step b). To initiate cell proliferation within two weeks of cultivation, the above mentioned medium was used. Simultaneously, chondrocytes from the same preculture were immobilized in alginate beads (1x106 cells per mL alginate) during two weeks for re-differentiation and production of cartilage matrix (step c).
After recovering cells from the gel, cartilage-constructs were prepared. Therefore, 1.8x106 re-differentiated cells were centrifuged onto each cell coated carrier, located in a special device [
During cultivation of alginate beads and cartilage-carrier-constructs, DMEM (PAA) supplemented with 10 % (v/v) porcine serum (PS, Gibco, Germany), penicillin/streptomycin (100 U mL-1 penicillin and 100 µg mL-1 streptomycin, PAA), 25 mM HEPES (4-(2-hydroxyethyl)-1-piperazineethanesulfonic acid, Roth), 0.28 mM L-ascorbic acid 2-phosphate and 1 mM cysteine (Sigma-Aldrich) was used to stimulate matrix production. Furthermore, during re-differentiation in alginate gel hIGF-I (100 ng mL-1, human recombinant Insulin like Growth factor 1, CellConcepts, Germany) and hTGF-β1 (10 ng mL-1, human recombinant Transforming Growth Factor beta1, CellConcepts) were added to the medium [
Medium was exchanged three times a week. All cultivations were performed at 37 °C under an atmosphere of 5 % (v/v) O2 and 5 % (v/v) CO2.
To quantify biochemical properties of cartilage constructs, DNA and glycosaminoglycan (GAG) content was determined according to Buschmann et al. [
For histological analysis carriers were removed from the constructs after cultivation by the help of tweezers and the generated tissue was fixed in formaldehyde (4 % in PBS, Roth). After dehydrating and embedding in paraffin, 5 µm thick histological sections were prepared with a microtome (Leica, Germany) on object slides (Histo-Bond®, Marienfeldt, Germany). Paraffin was removed by the aid of xylene. Afterwards, histological sections were rehydrated in solutions with decreasing alcohol concentrations.
The formation of collagen type I and collagen type II was confirmed by immunochemical staining of histological sections. In the first step, histological sections were immunostained separately with primary antibodies (Acris Antibodies, Germany) against collagen type I (clone I-8H5) or collagen type II (clone II-4C11). As secondary antibody, a biotinylated antibody (Goat anti-mouse, [IgG (H+L)-biotin], Southern Biotech, USA) was used. Afterwards, these sections were incubated with a streptavidin/alkaline phosphatase complex (Linaris, Germany) and the final color development was carried out with the New Fuchsin chromogen (Sigma-Aldrich) [
Distribution of glycosaminoglycans in the cultivated tissue was determined by a Safranin O staining. Therefore, hydrated sections were submerged in Fast Green solution (0.04 % in 0.2 % acetic acid, VWR, Germany), afterwards washed in 1 % acetic acid and then stained with Safranin O (0.2 % in 1 % acetic acid, Sigma-Aldrich).
The biomechanical parameters wet weight (Mettler AE200), height and the Young’s Modulus of the cartilage-constructs were determined. For measuring the height and the Young’s Modulus, a high-precision material testing equipment (Zwicki 1120, Zwick, Germany) was used. The Young’s Modulus was determined by stepwise stress-relaxation tests (five steps with 4 % of the uncompressed cartilage thickness each) according to Korhonen
Stability (interface between cartilage and carrier) was established qualitatively by pulling the cartilage carefully with a tweezers.
Scanning electron microscopy (SEM, Leo 1530, Zeiss, Germany) was used to photograph the cell coated carrier after two weeks in culture (step b). At the end of cultivation carriers were kept in a glutaraldehyde solution (5 % in PBS, Sigma-Aldrich) to fix the cells. After a minimum of one day, they were dehydrated by stepwise exchanging water with ethanol (20 %, 40 %, 60 %, 80 %, 100 % ethanol in PBS) and stored in 100 % ethanol. The next day, ethanol was exchanged with amyl acetate (Sigma-Aldrich) for two hours in an amyl acetate-ethanol mixture (1:1 v/v). Afterwards, carriers were stored in 100 % amyl acetate overnight. Before carrying out the SEM, the samples were critical-point dried (Balzers, Germany) and gold-sputter coated (Sputter Coated S150B, Edwards, United Kingdom’s).
Statistics software NCSS97 was applied to evaluate statistical significance of the data (p < 0.05, ANOVA).
Sponceram HA exhibits a disordered porous structure of coarse grains (compare Fig.
In a preliminary study, conventional grinding/polishing or ultrasonic milling using abrasive B4C particles, respectively, failed to create smooth and homogeneous surfaces [
In previous studies, we observed a poor adhesive strength between carrier and chondrocytes recovered from alginate gel (step d). It was found that cells grown on the carrier as a first monolayer are necessary to improve the bonding before re-differentiated chondrocytes are added [
In Fig. (
After evaluation of the developed cell layer, cartilage-carrier-constructs have been prepared using carriers with different surface structures. In addition, tissue engineered cartilage was generated without using any carrier.
The largest constructs were found for the cultivation without using a carrier which is shown by significantly higher wet weights and heights (Fig.
The significantly highest glycosaminoglycan content and GAG to DNA ratio have been reached for cartilage-constructs using no carrier (Fig.
Even though the histological sections in Fig. (
The immunohistological images (Fig.
In addition, the adhesive strength between carrier and tissue was estimated by applying subjective values. Cartilage was detached from the biomaterial with the help of tweezers and different adhesions were noted. The connection between tissue and biomaterial was weaker for constructs on top of carriers grinded with paper and ink jet foil than for untreated carriers.
One approach for the treatment of cartilage defects is the generation of autologous tissue
Research being carried out to determine cell-surface interaction concerning physical parameters of the biomaterial deals with particle size, porosity and topography using different cell types [
Additionally, cartilage-carrier-constructs were generated on top of carriers with three different surfaces during this study. A strong connection between cartilage to biomaterial interface is an important factor as it has to resist high shear stresses after implantation in the joint [
Slight differences could be observed between the biomechanical and biochemical quality of constructs. The wet weight, height and Young’s Modulus of cartilage cultured on the untreated carrier reached lower values than the other two conditions, but only the difference in height is significant. Also, histological staining for glycosaminoglycans (Fig.
Furthermore, it was demonstrated that tissue engineered cartilage cultured without any carrier yielded the significantly highest biochemical and biomechanical parameters (Figs.
Supplementary, tissue generation on top of a carrier is affected by a bad nutrient supply from the bottom. Diffusion of nutrients and gases are hindered by the carrier itself and the holding device for the carrier.
In conclusion, inhomogeneous and rough surfaces of hydroxylapatites support the proliferation and adhesion of cells and tissue, but lead to inferior quality of the engineered matrix (Table
Hydroxylapatite ceramics themselves have a negative effect on the quality of cartilage-constructs generated
It could be demonstrated that moderate surface structure modifications of commercial carriers causes slight changes in biomechanical quality of cartilage constructs, in the distribution of proteoglycans and collagens, in the adhesive strength between cartilage and biomaterial and in attachment and proliferation of a chondrocyte monolayer. This study delivered first interesting results of the influence of a hydroxylapatite carrier and its surface topography on the formation of cartilage tissue
We would like to thank Kerstin Michael and Ditte Siemesgelüss for their excellent technical support, Helge Paetzold for his help during Young’s Modulus measurements and Oscar for proofreading. The project was kindly supported by DFG (PO 413/7-1).
Alicona image of a Sponceram HA carrier as used in this investigation. The defects are most probably due to cracking along some large agglomerates formed during calcinations of the porcine bone (each scale bar = 4,55 mm).
Alicona images of (
SEM pictures of a cell layer grown on modified carrier surfaces (
Biomechanical parameters wet weight, height and Young’s Modulus of cartilage-constructs cultured (
Biochemical parameters glycosaminoglycan concentration, DNA concentration and GAG to DNA ratio of cartilage-constructs cultured (
Histological staining for glycosaminoglycans with Safranin O (
Immunohistological staining: left column for collagen type I, right column for collagen type II (
Summarization of Biochemical and Biophysical Parameters of Generated Cartilage Constructs (+ Positive Results; - Negative Results; +/- no Difference; ++ Significantly Highest Values)
| Surface Modification | w/o Carrier | Carrier as Received | Carrier Grinded with Paper | Carrier Grinded with Foil |
|---|---|---|---|---|
| Surface structure | rough and inhomogeneous | smooth | structured | |
| Proliferation (monolayer) | + | - | - | |
| Adhesive strength | + | - | - | |
| Biomechanical quality | ++ | - | + | + |
| Biochemical quality | ++ | +/- | +/- | +/- |
| Histology | ++ | - | + | + |