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Review
. 2010 Jan 5;43(1):156-65.
doi: 10.1016/j.jbiomech.2009.09.021. Epub 2009 Oct 7.

Shape, loading, and motion in the bioengineering design, fabrication, and testing of personalized synovial joints

Gregory M Williams  1 , Elaine F Chan, Michele M Temple-Wong, Won C Bae, Koichi Masuda, William D Bugbee, Robert L Sah
Affiliations
Review

Shape, loading, and motion in the bioengineering design, fabrication, and testing of personalized synovial joints

Gregory M Williams et al. J Biomech. .

Abstract

With continued development and improvement of tissue engineering therapies for small articular lesions, increased attention is being focused on the challenge of engineering partial or whole synovial joints. Joint-scale constructs could have applications in the treatment of large areas of articular damage or in biological arthroplasty of severely degenerate joints. This review considers the roles of shape, loading and motion in synovial joint mechanobiology and their incorporation into the design, fabrication, and testing of engineered partial or whole joints. Incidence of degeneration, degree of impairment, and efficacy of current treatments are critical factors in choosing a target for joint bioengineering. The form and function of native joints may guide the design of engineered joint-scale constructs with respect to size, shape, and maturity. Fabrication challenges for joint-scale engineering include controlling chemo-mechano-biological microenvironments to promote the development and growth of multiple tissues with integrated interfaces or lubricated surfaces into anatomical shapes, and developing joint-scale bioreactors which nurture and stimulate the tissue with loading and motion. Finally, evaluation of load-bearing and tribological properties can range from tissue to joint scale and can focus on biological structure at present or after adaptation.

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Conflict of interest statement

Conflict of Interest Statement:

None

Figures

Figure 1
Figure 1
Current treatment modalities for articular surface damage of varying size and severity. Focal defects (<1 cm2, arthroscopy image) treated with microfracture. Focal defects (1–2 cm2) treated with autograft mosaicplasty or (matrix-assisted) autologous chondrocyte implantation (ACI/M-ACI). Single or multiple large (2–4 cm2) defects treated with allografts. End-stage osteoarthritic degeneration treated by total joint replacement. Microfracture photo is reprinted with permission from Elsevier (Steinwachs, et al., 2008). Mosaicplasty and ACI photos are reprinted with permission from The Journal of Bone and Joint Surgery, Inc. (Hangody, et al., 2004, Jones and Peterson, 2006).
Figure 2
Figure 2
Synovial joint classifications based on geometry and examples.
Figure 3
Figure 3
Schematic of the types of A) whole-joint motions and B) cartilage surface contact motions. C) Tracking of tissue and cell deformations due to joint loading.
Figure 4
Figure 4
Developmental progression of biomimetic tissue engineering therapies for articular cartilage repair. Current therapies using ACI, M-ACI, and small chondral and osteochondral constructs, are advancing incrementally towards larger, more phenotypically stable and mature tissues at the time of implantation. Future engineered partial or whole-joint constructs may require or benefit from further in vitro maturation of tissues. Chondro-Gide®, ChondroCelect®, DeNovo®ET, and NeoCart® are products of Geistlich Pharma AG (Wolhusen, Switzerland), TiGenix (Leuven, Belgium), ISTO Technologies, Inc. (St. Louis, Missouri), and Histogenics Corporation (Waltham, Massachusetts), respectively.
Figure 5
Figure 5
Key challenges for advancing tissue engineering of partial or whole synovial joints include creating multiple tissue environments, specialized interfaces, complex tissue shapes, and bioreactors for the application of joint loading and motion.
Figure 6
Figure 6
Configurations for friction and wear testing of lubricated cartilage with varying complexity and physiological relevance. Friction and wear tests can be performed with small samples of cartilage in apposition to (A) a material or (B) cartilage, or with (C) whole-joint testing systems. Lubricant solutions within these systems may be varied to reflect various physiological states.
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