Mahmud Aydin1, Mesut Ok1, Mehmet Halis Cerci2, Ramazan Demirhan3, Serkan Surucu4, Mahir Mahirogullari2

1Department of Orthopedics and Traumatology, Haseki Training and Research Hospital, Istanbul, Türkiye
2Department of Orthopedics and Traumatology, Memorial Şişli Hospital, Istanbul, Türkiye
3Department of Bioengineering, Yıldız Technical University, Istanbul, Türkiye
4Department of Orthopaedics and Rehabilitation, Yale University, New Haven, USA

Keywords: Bioprinted, histopathological, microfracture, osteochondral defect, scaffold, Wakitani score.


Objectives: This study aims to compare the radiological, biomechanical, and histopathological results of microfracture treatment and osteochondral damage repair treatment with a new scaffold product produced by the three-dimensional (3D) bioprinting method containing gelatin-hyaluronic acid-alginate in rabbits with osteochondral damage.

Materials and methods: A new 3D bioprinted scaffold consisting of gelatin, hyaluronic acid, and alginate designed by us was implanted into the osteochondral defect created in the femoral trochlea of 10 rabbits. By randomization, it was determined which side of 10 rabbits would be repaired with a 3D bioprinted scaffold, and microfracture treatment was applied to the other knees of the rabbits. After six months of follow-up, the rabbits were sacrificed. The results of both treatment groups were compared radiologically, biomechanically, and histopathologically.

Results: None of the rabbits experienced any complications. The magnetic resonance imaging evaluation showed that all osteochondral defect areas were integrated with healthy cartilage in both groups. There was no significant difference between the groups in the biomechanical load test (p=0.579). No statistically significant difference was detected in the histological examination using the modified Wakitani scores (p=0.731).

Conclusion: Our study results showed that 3D bioprinted scaffolds exhibited comparable radiological, biomechanical, and histological properties to the conventional microfracture technique for osteochondral defect treatment.

Citation: Aydin M, Ok M, Cerci MH, Demirhan R, Surucu S, Mahirogullari M. A comparative analysis of 3D bioprinted gelatin-hyaluronic acid-alginate scaffold and microfracture for the management of osteochondral defects in the rabbit knee joint. Jt Dis Relat Surg 2024;35(2):361-367. Doi: 10.52312/ jdrs.2024.1626.

Ethics Committee Approval

The study protocol was approved by the Marmara University Animal Experiments Local Ethics Committee (date: 14.12.2021, no: 99.2021mar). The study was conducted in accordance with the principles of the Declaration of Helsinki.

Author Contributions

Idea/concept: M.M., M.H.C.; Design: M.A., M.O.; Data collection/processing: M.A., M.H.C.; Analysis/interpretation: S.S., M.A.; Literature review: R.D., M.A., Drafting/writing: M.O., M.H.C., M.A.; Critical review: M.A., S.S., M.M.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.