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A Novel Approach for Multiple Material Extrusion in Arthroscopic Knee Surgery
Tommaso Mazzocchi1,2, Daniele Guarnera3,4, Diego Trucco1,2,5
1The BioRobotics Institute, Scuola Superiore Sant'Anna, Piazza Martiri della Liberta' 33, 56127, Pisa, Italy.
Annals of Biomedical Engineering
|September 3, 2022
Summary
This study introduces a novel arthroscopic device for minimally invasive cartilage repair, enabling simultaneous deposition of multiple biomaterials with a flexible tip for hard-to-reach areas. The device ensures safe and effective delivery, promoting cartilage regeneration.
Area of Science:
- Biomedical Engineering
- Regenerative Medicine
- Orthopedics
Background:
- Articular cartilage defects cause pain and joint dysfunction, often requiring joint replacement.
- Current cartilage regeneration methods focus on biomaterial deposition but lack minimally invasive tools.
- Existing tools are limited in their ability to deliver multiple biomaterials precisely.
Purpose of the Study:
- To develop and characterize an innovative device for minimally invasive, multi-biomaterial deposition in arthroscopic procedures.
- To assess the device's ability to deliver biomaterials to damaged cartilage, including remote and difficult-to-access regions.
- To ensure the safety and efficacy of the biomaterial extrusion process for cell viability.
Main Methods:
- Design and fabrication of a novel arthroscopic tool with a flexible, bendable tip and three coaxial channels.
- Experimental testing of the tip's mechanical properties (bending up to 90° at ~1.5 N).
- Rheometric analysis and computational fluid dynamics (CFD) simulations to evaluate biomaterial flow and shear stress.
- In vitro cell viability assessment using Live/Dead assays post-extrusion.
- In vivo arthroscopic testing in a cadaveric knee model.
Main Results:
- The device successfully extrudes three coaxial biomaterials simultaneously through a flexible tip, even when bent to 90°.
- Shear stress during extrusion (max ~1.2 kPa) is compatible with cell viability.
- Live/Dead assays confirmed high cell viability after extrusion, indicating a safe procedure.
- Arthroscopic testing in a cadaveric knee demonstrated effective delivery to various joint areas, including challenging locations.
Conclusions:
- The developed arthroscopic device offers a promising solution for minimally invasive cartilage regeneration.
- Its ability to deliver multiple biomaterials flexibly and safely enhances potential therapeutic outcomes.
- This innovation could advance cartilage repair strategies, potentially reducing the need for joint replacement.
