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Arthritis Res Ther. 2004; 6(5): R469–R476.
Published online 2004 August 6. doi:  10.1186/ar1216
PMCID: PMC546287
Improved cartilage integration and interfacial strength after enzymatic treatment in a cartilage transplantation model
Jarno van de Breevaart Bravenboer,1 Caroline D In der Maur,2 P Koen Bos,1 Louw Feenstra,2 Jan AN Verhaar,1 Harrie Weinans,1 and Gerjo JVM van Oschcorresponding author1,2
1Erasmus Orthopaedic Research Laboratory, Department of Orthopaedics, Erasmus University Medical Center, Rotterdam, The Netherlands
2Department of Otorhinolaryngology, Erasmus University Medical Center, Rotterdam, The Netherlands
corresponding authorCorresponding author.
Jarno van de Breevaart Bravenboer: j.vandebreevaartbravenboer/at/erasmusmc.nl; Caroline D In der Maur: c.indermaur/at/erasmusmc.nl; P Koen Bos: k.bos/at/erasmusmc.nl; Louw Feenstra: l.feenstra/at/erasmusmc.nl; Jan AN Verhaar: j.verhaar/at/erasmusmc.nl; Harrie Weinans: h.weinans/at/erasmusmc.nl; Gerjo JVM van Osch: g.vanosch/at/erasmusmc.nl
Received March 18, 2004; Revisions requested May 4, 2004; Revised May 30, 2004; Accepted June 23, 2004.
Abstract
The objective of the present study was to investigate whether treatment of articular cartilage with hyaluronidase and collagenase enhances histological and mechanical integration of a cartilage graft into a defect. Discs of 3 mm diameter were taken from 8-mm diameter bovine cartilage explants. Both discs and annulus were either treated for 24 hours with 0.1% hyaluronidase followed by 24 hours with 10 U/ml collagenase or left untreated (controls). Discs and annulus were reassembled and implanted subcutaneously in nude mice for 5 weeks. Integration of disc with surrounding cartilage was assessed histologically and tested biomechanically by performing a push-out test. After 5 weeks a significant increase in viable cell counts was seen in wound edges of the enzyme-treated group as compared with controls. Furthermore, matrix integration (expressed as a percentage of the total interface length that was connected; mean ± standard error) was 83 ± 15% in the treated samples versus 44 ± 40% in the untreated controls. In the enzyme-treated group only, picro-Sirius Red staining revealed collagen crossing the interface perpendicular to the wound surface. Immunohistochemical analyses demonstrated that the interface tissue contained cartilage-specific collagen type II. Collagen type I was found only in a small region of fibrous tissue at the level of the superficial layer, and collagen type III was completely absent in both groups. A significant difference in interfacial strength was found using the push-out test: 1.32 ± 0.15 MPa in the enzyme-treated group versus 0.84 ± 0.14 MPa in the untreated controls. The study shows that enzyme treatment of cartilage wounds increases histological integration and improves biomechanical bonding strength. Enzymatic treatment may represent a promising addition to current techniques for articular cartilage repair.
Keywords: cartilage integration, cartilage repair, enzyme, push-out test
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