Distraction Osteogenesis Combined With Tissue-Engineered Cartilage in the Reconstruction of Condylar Osteochondral Defect

Abstract

Surgical rehabilitation of condylar osteochondral defect remains a challenge for surgeons. The aim of this study was to explore the feasibility of combining distraction osteogenesis with tissue-engineered cartilage in the reconstruction of condylar osteochondral defect. A condylar defect model was established in 18 goats that were randomly divided into 2 groups: the experimental group and the control group. Mandibular ramus osteotomies were performed and distractors were implanted in all animals. The mixture of chondrocytes and Pluronic F-127 (Sigma-Aldrich, St Louis, MO) was injected on the notched surface of a transport disc in the experimental group, whereas a scaffold without cells was transplanted into the control group. After a 5-day latency period, distraction was activated at a rate of 0.5 mm twice per day for 15 days. The goats were killed at the end of the fourth, eighth, or twelfth week in the consolidation period. Specimens were harvested and macroscopic evaluation, as well as Masson trichrome and immunohistochemical staining, were performed to compare the results between the 2 groups. Osteogenesis was found in all animals with no evidence of infection. Condyle-like structures were formed at the upper end of the transport segment in all animals. The neocondylar surface was covered with a layer of smooth lustrous fibrocartilage in the experimental group. Collagen was shown in the reparative tissue by Masson trichrome staining. Immunohistochemistry staining indicated that type II collagen was positive, whereas type I collagen was negative on the neocondylar surface in the experimental group. No cartilage-like tissue was seen, but fibrous tissue was identified at the bony surface in the control group. In the experimental group, immunofluorescent semiquantitative analysis showed that the positive rate of type II collagen was 1.62% ± 0.53% after the fourth week of consolidation, and it increased to 12.39% ± 3.27% after the twelfth week. There was a significant difference in the expression of type II collagen between the goats examined after the fourth week, and those examined after the twelfth week. The combination of distraction osteogenesis with tissue-engineered cartilage is an ideal alternative in the reconstruction of condylar osteochondral defect. By use of this method, the simultaneous rehabilitation and regeneration of condylar bone and cartilage were achieved.