Meniscal allograft sterilisation: effect on biomechanical and histological properties
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ORIGINAL ARTICLE
Meniscal allograft sterilisation: effect on biomechanical and histological properties David Bui • Vedran Lovric • Rema Oliver • Nicky Bertollo • David Broe • William R. Walsh
Received: 23 September 2014 / Accepted: 30 December 2014 Ó Springer Science+Business Media Dordrecht 2015
Abstract Sterilisation of allografts are a crucial step in ensuring safety and viability. Current sterilisation standards such as 25 kGy gamma irradiation (c) can have adverse effects on the ultrastructure and biomechanical properties of allograft tissue. Supercritical CO2 (SCCO2) technology, represents an improved sterilisation process that potentially preserves tissue properties. This study aimed to test the effect of SCCO2 sterilisation on the biomechanical and histological properties of the meniscus and compare this to the current standard of c. Thirty-two 18-month old ovine menisci were randomly assigned into three groups for sterilisation (SCCO2, c and control). After treatment, biomechanical indentation testing (stiffness and stress relaxation) or histological analysis [percentage of void, cells and extracellular matrix (ECM) per slide] was undertaken. Both SCCO2 and gamma groups displayed an increase in stiffness and stress relaxation as compared to control, however, this difference was lesser in samples treated with SCCO2. No significant histological quantitative differences were detected between SCCO2 and control specimens. Gamma-
D. Bui V. Lovric R. Oliver N. Bertollo D. Broe W. R. Walsh (&) Surgical and Orthopaedic Research Laboratories Prince of Wales Clinical School, Prince of Wales Hospital, University of New South Wales, Level 1 Clinical Sciences Building, Avoca St Randwick, Sydney, NSW 2031, Australia e-mail: [email protected]; [email protected]
treated samples demonstrated a significant increase in void and decrease in ECM. Interestingly, both treatment groups demonstrated a decreasing mean void and increasing ECM percentage when analysed from outer to inner zones. No significant differences were detected in all-endpoints when analysed by section. SCCO2 sterilisation represents a potential feasible alternative to existing sterilization techniques such as c. Keywords Meniscus Allograft Supercritical carbon dioxide Gamma irradiation Sterilisation and Biomechanical
Introduction The menisci of the knee are two C-shaped wedges of fibrocartilage secured onto the tibial surface. They are crucial to the healthy operation of the knee joint (Brindle et al. 2001; Harner and Lo 2009). Current treatments for meniscal tears in the avascular, inner ‘‘white zone’’ in the knee are ineffective, as first line treatments such as partial meniscectomy can lead to degeneration and osteoarthritis (Englund et al. 2012; Lee et al. 2012). Meniscal allograft transplantation (MAT) is an emerging technique which has had promising results (Lubowitz et al. 2007; Rijk 2004; Stone et al. 2010; Verdonk et al. 2005). Sterilisation of allografts are a crucial step in ensuring safety and viability. Sterilization is
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