Arthroscopic device with bendable tip for the controlled extrusion of hydrogels on cartilage defects.

Autor: Guarnera D; The BioRobotics Institute, Scuola Superiore Sant'Anna, Piazza Martiri della Liberta' 33, 56127, Pisa, Italy. daniele.guarnera@santannapisa.it.; Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Piazza Martiri della Liberta' 33, 56127, Pisa, Italy. daniele.guarnera@santannapisa.it., Restaino F; The BioRobotics Institute, Scuola Superiore Sant'Anna, Piazza Martiri della Liberta' 33, 56127, Pisa, Italy.; Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Piazza Martiri della Liberta' 33, 56127, Pisa, Italy., Vannozzi L; The BioRobotics Institute, Scuola Superiore Sant'Anna, Piazza Martiri della Liberta' 33, 56127, Pisa, Italy.; Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Piazza Martiri della Liberta' 33, 56127, Pisa, Italy., Trucco D; The BioRobotics Institute, Scuola Superiore Sant'Anna, Piazza Martiri della Liberta' 33, 56127, Pisa, Italy.; Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Piazza Martiri della Liberta' 33, 56127, Pisa, Italy.; IRCCS Istituto Ortopedico Rizzoli, SC Laboratorio di Immunoreumatologia e Rigenerazione Tissutale, Via di Barbiano, 1/10, 40136, Bologna, Italy., Mazzocchi T; Relief S.R.L, Viale Rinaldo Piaggio 32, 56025, Pontedera, Italy., Worwąg M; Vimex Endoscopy, Ul. Toruńska 27, 44-122, Gliwice, Poland., Gapinski T; Lega Medical Sp. Z o. O, ul. Majowa 11, 44-217, Rybnik, Poland., Lisignoli G; IRCCS Istituto Ortopedico Rizzoli, SC Laboratorio di Immunoreumatologia e Rigenerazione Tissutale, Via di Barbiano, 1/10, 40136, Bologna, Italy., Zaffagnini S; IRCCS Istituto Ortopedico Rizzoli, Orthopaedic and Traumatologic Clinic, Via di Barbiano, 1/10, 40136, Bologna, Italy., Russo A; IRCCS Istituto Ortopedico Rizzoli, Orthopaedic and Traumatologic Clinic, Via di Barbiano, 1/10, 40136, Bologna, Italy., Ricotti L; The BioRobotics Institute, Scuola Superiore Sant'Anna, Piazza Martiri della Liberta' 33, 56127, Pisa, Italy.; Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Piazza Martiri della Liberta' 33, 56127, Pisa, Italy.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2024 Aug 27; Vol. 14 (1), pp. 19904. Date of Electronic Publication: 2024 Aug 27.
DOI: 10.1038/s41598-024-70426-2
Abstrakt: Advanced tools for the in situ treatment of articular cartilage lesions are attracting a growing interest in both surgery and bioengineering communities. The interest is particularly high concerning the delivery of cell-laden hydrogels. The tools currently available in the state-of-the-art hardly find an effective compromise between treatment accuracy and invasiveness. This paper presents a novel arthroscopic device provided with a bendable tip for the controlled extrusion of cell-laden hydrogels. The device consists of a handheld extruder and a supply unit that allows the extrusion of hydrogels. The extruder is equipped with a disposable, bendable nitinol tip (diameter: 4 mm, length: 92 mm, maximum bending angle: 90°) that guarantees access to hard-to-reach areas of the joint, which are difficult to get to, with conventional arthroscopic instruments. The tip accommodates a biocompatible polymer tube that is directly connected to the cartridge containing the hydrogel, whose plunger is actuated by a volumetric or pneumatic supply unit (both tested, in this study). Three different chondrocyte-laden hydrogels (RGD-modified Vitrogel®, methacrylated gellan gum, and an alginate-gelatine blend) were considered. First, the performance of the device in terms of resolution in hydrogel delivery was assessed, finding values in the range between 4 and 102 µL, with better performance found for the pneumatic supply unit and no significant differences between straight tip and bent tip conditions. Finite element simulations suggested that the shear stresses and pressure levels generated during the extrusion process were compatible with a safe deposition of the hydrogels. Biological analyses confirmed a high chondrocyte viability over a 7-day period after the extrusion of the three cell-laden hydrogel types, with no differences between the two supply units. The arthroscopic device was finally tested ex vivo by nine orthopedic surgeons on human cadaver knees. The device allowed surgeons to easily deliver hydrogels even in hard-to-reach cartilage areas. The outcomes of a questionnaire completed by the surgeons demonstrated a high usability of the device, with an overall preference for the pneumatic supply unit. Our findings provide evidence supporting the future arthroscopic device translation in pre-clinical and clinical scenarios, dealing with osteoarticular treatments.
(© 2024. The Author(s).)
Databáze: MEDLINE
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