Revolutionizing Cartilage Repair: Combining the VitroGel® System with a Bendable-Tip Arthroscopic Device for Controlled Hydrogel Extrusion

The development of advanced tools for the in-situ treatment of articular cartilage lesions is gaining significant attention within both the surgical and bioengineering communities. A key area of interest is the delivery of cell-laden hydrogels, which hold great promise for cartilage repair. However, current state-of-the-art tools struggle to balance treatment accuracy with minimal invasiveness.

This workshop introduces a novel arthroscopic device featuring a bendable tip designed for the controlled extrusion of cell-laden hydrogels. The device comprises a handheld extruder and a supply unit, enabling precise hydrogel delivery. The extruder is equipped with a disposable, bendable nitinol tip, which provides access to hard-to-reach areas of the joint that are typically inaccessible with conventional arthroscopic instruments. The tip incorporates a biocompatible polymer tube connected directly to a hydrogel-filled cartridge. The hydrogel is extruded using either a volumetric or pneumatic supply unit, both of which were tested in this study.

Three types of chondrocyte-laden hydrogels were evaluated: RGD-modified VitroGel®, methacrylated gellan gum, and an alginate-gelatin blend. Biological analyses confirmed high chondrocyte viability over a 7-day period post-extrusion, with no significant differences observed between the two supply units.

The device was further tested ex vivo by nine orthopedic surgeons on human cadaver knees. Feedback from a usability questionnaire indicated high satisfaction with the device, with a clear preference for the pneumatic supply unit.

These findings highlight the potential of this arthroscopic device for future translation into pre-clinical and clinical settings, offering a promising solution for osteoarticular treatments. By combining precision, minimal invasiveness, and high usability, this innovation represents a significant step forward in the field of cartilage repair.

KEY TAKEAWAYS:

• The new arthroscopic device guarantees access to hard-to-reach areas of the joints.
• A correct delivery of hydrogel is crucial for cartilage regeneration.
• Chondrocyte-laden hydrogels represent a new frontier for the treatment of osteoarthritis.

Daniele Guarnera earned his master’s degree in 2015 from Politecnico di Torino, where he defended a thesis on the interaction between pantographs and rigid catenaries, developed in collaboration with Universitat Politecnica de Catalunya.

In 2019, he completed his Ph.D. at Politecnico di Torino with a thesis titled “Refined one-dimensional models applied to biostructures and fluids.” Conducted within the Mul2 research group under the guidance of Professor Erasmo Carrera, his Ph.D. focused on advanced structural and fluid-dynamical numerical models for biomechanics. He also collaborated with the University of Massachusetts, where he contributed to the mechanical characterization of 3D-printed human artery phantoms.

In 2020, Dr. Guarnera joined the Regenerative Technologies Lab at The BioRobotics Institute of Scuola Superiore Sant’Anna for his post-doctoral training, working under Professor Leonardo Ricotti. His research spans numerical and experimental methods in material science, structural engineering, biomechanics, and computational fluid dynamics. As a skilled computer modeler, he has contributed to several Italian and European projects, including ADMAIORA, REBORN, and BIOMELD.

Currently, Dr. Guarnera serves as a Project Manager in the FORGETDIABETES EU project, developing an artificial pancreas. He is also involved in the design of bio-actuators and biomedical devices, such as the arthroscopic tool showcased in this workshop. His work continues to bridge innovation and application in biomedical engineering.