Abstract
BACKGROUND: Autologous chondrocyte implantation, a 2-stage, costly procedure, has limitations, prompting the development of 1-step techniques utilizing autologous minced cartilage (MC). However, novel scaffolds for cell migration and proliferation are needed to enhance their effectiveness. PURPOSE: To evaluate the effectiveness of silk-elastin and SpheroSeev (SESS) scaffolds in enhancing chondrocyte activity and promoting cartilage repair in a rabbit model of osteochondral defect repair. STUDY DESIGN: Controlled laboratory study. METHODS: The effects of a SESS mixture combined with MC on cartilage repair in osteochondral defects were investigated in 42 Japanese White rabbits, with the defect (Df) group serving as the control. Bilateral osteochondral defects were created in the knees of 36 rabbits, treated with MC, SESS, and a combination of MC and SESS, with all treated sites sealed using fibrin glue. Osteochondral cartilage repair was evaluated using the modified O'Driscoll histological scoring, immunohistochemistry for collagen type II expression, and Ki67 staining for cell proliferation at 8, 12, and 24 weeks postoperatively. RESULTS: SESS alone and in combination with MC significantly enhanced osteochondral cartilage repair in the rabbit models by 24 weeks compared with the Df group (P < .05). Among them, histological scoring was higher in the SESS group (20.7 ± 6) than in the Df and MC groups (8.8 ± 6.7, P = .046; 7.8 ± 5.7, P = .023). This resulted in smooth surfaces and histological features similar to normal cartilage. Immunohistochemical analyses revealed improved repair quality with increased expression of type II collagen and Ki67, indicating superior repair and cellular activity relative to the controls. CONCLUSION: The combined use of SESS and MC effectively promoted cartilage repair in rabbit osteochondral defects. Notably, the SESS mixture appears to enhance the structural and compositional repair of cartilage tissue, offering a promising approach for the treatment of osteochondral defects. CLINICAL RELEVANCE: The novelty of this approach lies in combining silk-elastin and recombinant spider silk fibers, both of which provide mechanical support and promote cell proliferation, making them promising candidates for enhancing cartilage repair in osteochondral defects. Utilizing the SESS mixture as a scaffold for cartilage repair in osteochondral defects offers a 1-step, cost-effective alternative to traditional autologous chondrocyte implantation, potentially enhancing cartilage repair and improving tissue structure and biochemistry.