Aim of the study: The purpose of the study was to evaluate whether the implantation of a mixed type I-type II collagen scaffold associated with subchondral perforations, would improve the reparative outcomes of sub-chondral perforations by themselves, in rabbit articular cartilage lesions, over a period of 6 months.

Materials and Methods: Ten NZW rabbits were operated bilaterally on knees. Two chondral defects of 5 mm diameter were produced in each condyle in a standardized manner, without penetrating the subchondral bone. At random, one of these lesions was treated with sub-chondral perforations, and the other with subchondral perforations and apposition of the type I-type II collagen scaffold. The membrane was secured with a transosseus stitch. The overall number of lesions was forty; twenty treated defects and twenty control defects. Rabbits were killed after six months since surgery. Then histological and histomorphometrical evaluation were performed. The O’Driscoll score was used to evaluate the quality of reparative tissue.

Results: The amount of defect fill resulted significantly greater in treated lesions rather than in control lesions. The defect fill increased from 60% to 85% of the total area of the lesion. From a histological point of view, the quality of reparative tissue improved with the addition of the scaffold, as resulted by an increase in O’Driscoll Score. Particularly, hyaline-like tissue was detected in 75% of treated lesions, rather than in 15% of control lesions.

Conclusions: The addition of a mixed type I-type II collagen membrane enhances reparative effects given by subchondral perforations. Both the histological and structural quality of the reparative tissue, both the percentage area of defect fill result to be improved by this kind of membrane.

Aims: A new type I collagen membrane developed for use as a tendon graft was tested in vitro and in vivo.

Methods: The membrane (Opocrin, Italy) is obtained from type-I collagen harvested from equine Achilles tendon and is composed of collagen I fibres oriented in a single direction. It is isotropic, resorbable, hygroscopic and non immunogenic acellular membrane.

Primary human fibroblasts were seeded on collagen I membranes with aligned fibres (# 40133) with and randomly arranged fibres (# 40153). Cell proliferation was evaluated at 4, 8 and 12 days by spectrophotometry. Membrane sections were studied by immunohistochemistry and by confocal microscope on day 12 of culture.

The middle third of the patellar tendon was lesioned bilaterally in 10 adult male New Zealand White rabbits and repaired on the right side by a graft (# 40133). The contralateral tendon was left untreated and served as control. Animals were euthanized 1 or 6 months after surgery and the tendon grafts subjected to histological examination.

Results: The in vitro study demonstrated cell viability and proliferation already on day 4 from membrane seeding.

Cells were homogeneously distributed, with a more marked orientation along the main membrane axis in batch 40133 than in 40153. The in vivo study showed that cell orientation and differentiation in the scaffold with aligned fibres was satisfactory, with decreased cellularity, good integration with the surrounding tissue and crimp formation. Inflammatory reaction or excessive implant neovascularization were never observed.

Conclusion: The new type I collagen membrane exhibited a behaviour similar to other tendon or ligament scaffolds. Fibre orientation in the membrane with aligned fibres allowed to obtain a quick and well-oriented cell growth. The membrane appears to be suitable for application in tendon and ligament repair and substitution.